Medicalizing Modern Motherhood in the Americas

Women's bodies have borne out the trials of modernization, for better or worse, even in the most intimate domain of reproductive practices. Latin American gender scholars have demonstrated that, contrary to the stated goals of modernization theory, women's lives and livelihoods came under more scrutiny and regulation as their respective nation-states adopted the liberal tools of modernization intended to optimize society and its products. As gendered knowledge about science and medicine tended toward male-produced discourses and practices in the public sphere, the balance of power shifted away from the midwives and moms operating in the privacy of home birthing chambers.

But lest this transition—a global phenomenon situated in the apex of liberal modernization at the turn of the twentieth century—be cast as a universal truth, three historians of the politics of fertility and childbirth in Latin America remind us of the importance of context. Collectively spanning the late colonial period (eighteenth century) through the twentieth century, these studies from Mexico, Brazil, and Puerto Rico can be organized chronologically to construct a narrative of Latin American modernization mapped on women's birthing experiences. Together, they confirm the argument that women's agency over their reproductive health succumbed to the paternalistic welfare (or developing) state. But they each powerfully nuance this tidy narrative in their own way by demonstrating the mitigating factors played by regionalism and race, midwives and monsters. This review examines the common themes that emerge from fusing together the fraught relationship between women and the emerging nation-states across the Americas in Nora Jaffary's Reproduction and Its Discontents in Mexico: Childbirth and Contraception from 1750 to 1905, Okezi Otovo's Progressive Mothers, Better Babies: Race, Public Health, and the State in Brazil, 1850–1945, and Isabel M. Córdova's Pushing in Silence: Modernizing Puerto Rico and the Medicalization of Childbirth (from 1948 to 2000).

Jaffary fills in a woefully thin scholarship of emergent Creole nationalism in late colonial and early national Mexico with her rich history that places discourses and practices of fertility and childbirth at the center of this critical moment of transition. She organizes her argument into three sections that move the reader both conceptually and chronologically through the period. The first section, concerned with virginity, conception, and pregnancy, establishes the structure of female honor and morality in late colonial discourse, as well as its permeability. The second section examines the ways that women sought to cast off the mantle of motherhood, with chapters on the "hidden history" of contraception, abortion, and infanticide. The third section is on the politics of reproduction as nationalist practice, and examines discursive shifts by nation-building officials and medical professionals as they scrambled to frame the phenomenon of anomalous or "monstrous" births (births of multiples, conjoined births, excess hair or appendages, or other physical abnormalities) in the context of Mexican exceptionalism. The study concludes with the widespread practice of modern gynecological practice, with its literal instruments of intervention in women's birth canals as a metaphor for "birthing the nation" (207–208) to an institutionalized modern Mexico recognizable to readers, but with ambivalent outcomes for the health and well-being of the women producing its citizens.

Reproduction and Its Discontents puts to rest any assumptions that the advent of liberalism wrested barbaric Mexico from its backward medical practices and delivered it into the halls of modernity. Instead, Jaffary argues, when it came to women's well-being, political liberalism moved them in a "retrogressive...