INVISIBLE LABOR

A sharp account of an agonizing experience of childbirth.

Journalist Somerstein makes her book debut with a raw chronicle of the birth of her first child, which culminated in an unplanned Cesarean section. Because anesthesia failed, she suffered horrifically searing pain and a protracted period of healing. She also suffered severe emotional trauma, ending up with lifelong PTSD—a response, she learned, that affects nearly one in five women who give birth. The author’s anger over that traumatic experience infuses her investigation of the medical, social, and cultural history of C-sections and, more broadly, of a medical system that denies pregnant women’s autonomy and discredits or ignores women’s pain. C-sections, she reports, have become the most common operation in the world, accounting for 31.8% of births in the U.S. Furthermore, “Black, Hispanic/Latinx, and Asian women are disproportionately more likely than whites to have C-sections.” First developed on dead or dying women, with the aim of saving either the fetus or the mother, C-section technique in the U.S. was honed on enslaved people and, during a wave of eugenics, on women deemed unfit to bear more children. Somerstein sees the current uptick in C-sections as evidence of physician hubris and the rampant medicalization of childbirth, including an increased reliance on technology such as electronic fetal monitoring and ultrasounds. The author also discovered that hospitals are incentivized to promote technological responses to childbirth “because these are the kinds of care that insurance companies reward.” If midwives were more fully integrated into childbirth care, as Somerstein advocates, the rate of C-sections likely would be diminished. The author draws on considerable research, including interviews “with midwives, physicians, sociologists, historians, doulas, therapists, and other parents”—conversations, she writes, that “helped me to better understand how what happened to me could have happened.”

A hard-hitting critique of a persistent problem.