Progressive Mothers, Better Babies: Race, Public Health, and the State in Brazil, 1850–1945 by Okezi Otovo (review)

In Progressive Mothers, Better Babies, Okezi Otovo explores motherhood and its various meanings in Brazil from the mid-nineteenth to the mid-twentieth century. The author focuses on "maternalism," which she defines as the "intersecting medical and cultural discourses, health policies and institutions, and the construction of a welfare state—all with mothers and women's child-rearing activities at their core" (2). Set against the backdrop of the end of the Brazilian slave trade, the abolition of slavery, the transition from empire to republic, and the Vargas era dictatorship, one might assume that maternalism, especially as it pertained to lower-class black and brown mothers, was insignificant to these key national developments. However, Otovo argues that the "complex ideas, experiences, and versions of motherhood, public health, and national identity were intimately, inseparably related and pivotal to the political, cultural, and social climate of Brazil between 1850 and 1945" (2). The author selects Bahia, with its sizeable African-descendent population, as her main geographical focus. Working against the dominant scholarly marginalization of this state in discourse on modern(izing) Brazil, Otovo demonstrates how Bahia was often at the forefront of developing maternalist policies and programs.

Following an introduction, Otovo divides her examination into five main chapters, each revolving around a particular "character." The author begins her discussion in Chapter 1 with Bahia—the "mulata velha" or "old black mammy," as it is nicknamed. Otovo traces maternalism's emergence over the second half of the nineteenth century, as white Brazilians grew increasingly anxious about the end of slavery and empire. With the establishment of a republic, motherhood become more important in both medical and cultural understandings of gender, race, and family. Bahia's medical community embraced the French theory of "puériculture" or "puericultura"—a scientific approach to childcare, in order to improve, among other things, infant survival rates. Chapter 2 features the "mãe preta" in her shifting role from pre-abolition wet nurse and caretaker for white children, to post-abolition domestic servant, who had her own children at home. The author demonstrates how although Bahian maternalist organizations were founded to support a post-slavery population, whites' understanding of black motherhood was still shaped by slave-era notions. Only after the biomedical community realized that black and brown mothers were plagued by lack of access to health services, rather than fear of modern medicine, did they begin to create more successful health programs.

The remaining three chapters of the book overlap chronologically and cover the 1930s and 1940s. Chapter 3 takes the "mãe desnaturada" or the disgraced and unnatural mother, who did not breastfeed her own child, as its main character. Otovo discusses how during these two decades, the maternalist movement focused its attention on "motherless" children. It designed welfare programs that would enable economically challenged women, including those whose employment did not allow for breastfeeding, to keep their children. The author traces the history of institutions that received children surrendered by their parent(s), and their efforts to encourage temporary, rather than permanent, separation of mother and child. Chapter 4 contrasts the "curiosa" or folk midwife, who was the traditional expert on childbirth, with physicians and biomedically trained midwives, who were the new authorities on the subject. The overwhelmingly white, male biomedical community's efforts to change both low- and high-class Bahian women's childbirthing practices, by discrediting the black and brown folk midwives, proved unsuccessful. Ultimately, the physicians had to include these women in their educational programs in order to make their science based approach toward birthing and early childcare normative. Chapter 5 highlights the "pai dos pobres" or "father of the poor," as President Vargas was affectionately known, and his Estado Novo dictatorship. The author examines the disconnect between the male, patriarchal focus of Vargas era politics and the female, maternal focus of Bahian health and welfare politics. Further, she demonstrates how...