Invisible labor The untold story of the cesarean section

Review by Publisher's Weekly Review

This excellent debut investigation from Somerstein, a journalism professor at SUNY New Paltz, explores the history of and controversies surrounding the C-section. She explains that the operation emerged in the 500s and was usually performed on "dead or dying women in an effort to save," or at least baptize, their babies, few of whom survived. The operation was still considered controversial for imperiling mothers' lives in the 1800s, when American physicians began testing how to reduce its mortality rate by experimenting on enslaved Black women, who received no anesthesia and were said to "not feel pain as deeply as civilized, white women." C-sections became safer by the end of the century and doctors started marketing them to upper-class white women, who "were believed to be delicate and constitutionally unable to withstand" labor pains. Today, C-sections comprise about one in three births in the U.S., despite research showing they're 80% more likely than vaginal births to cause serious complications. According to Somerstein, hospitals overuse the procedure because it's faster and allows more patients to be seen (and charged) per day. The damning history highlights how sexism and racism have shaped women's healthcare for centuries, and Somerstein includes her own harrowing account of having an unplanned C-section while insufficiently anesthetized, an experience that left her with PTSD. This is a must-read. Agent: Veronica Goldstein, Fletcher & Company. (June)

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Review by Library Journal Review

Somerstein's (journalism, State Univ. of New York at New Paltz) debut book, in addition to being a history of the Caesarean section birth, draws attention to the deeply internalized sense of fear and shame many women have about C-sections, one of the most frequently performed major surgeries in the U.S. She shares the trauma that resulted from her own unplanned C-section and how it affected her in both visible and invisible ways. Her book addresses systemic failures that she asserts are ignored more often than not. Her research meticulously demonstrates that many women lack access or face barriers to health care due to their race--the maternal death rates of Black women in America are staggeringly high--and to their socioeconomic status. Somerstein asserts that the medical industry places most of the responsibility to safely carry a baby to term on pregnant women. She investigates the historical, medical, and dangerous aspects of C-sections to prove that her call for reproductive justice is needed. VERDICT This inciting, empowering book shows the clear need not just to improve women's access to health care but also to shift the paradigm about the restrictions placed on reproductive rights.--Emily Bowles

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Review by Kirkus Book Review

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. Copyright (c) Kirkus Reviews, used with permission.

Copyright (c) Kirkus Reviews, used with permission.

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