[4.25/5] INVISIBLE LABOR by Rachel Somerstein peels back the centuries-old layers of misogyny and racism behind the business of childbirth and, specifically, cesarean sections (C-sections). After enduring her own traumatic and emergency C-section, Somerstein, as a way to cope and understand, decided to investigate the history of C-sections. This effort inevitably grew in scope to include intersectionality of gender and race and how that affects the likelihood of birthing via C-section.

I want to start off by saying my review of this book cannot do it justice. Somerstein did a wonderful job researching and distilling all the information into ~330 pages, including references. So I direct any reader to this book for a fuller discourse on any topics I mention herein. That said, this book is, I feel, so important to read by anyone in the U.S. considering childbirth.

First, let's start with birth trauma as a whole. It comes as no surprise that many people who give birth don't have their pain or emotional welfare taken seriously. As Somerstein writes, there is "the cultural expectation that a mother's pain should be negated by that triumphant moment of union with her baby" (Loc 1186). From the time the pregnant person begins to report to the doctor for monitoring their care is overwhelmingly about the fetus rather than the birthing parent. (And, in general, physicians often dismiss women's pain.) I was shocked to learn that hundreds of years ago this was not the case. In fact, the health of the mother often came first and if the fetus threatened that, the physicians prioritized the mother's life. The methods weren't pretty and because of that the Catholic Church essentially put a moratorium on those procedures. This encouraged physicians to come up with other methods, such as postmortem or forced C-sections, to "save the soulds of the fetuses and not the lives of the mothers" (Loc 1221).

INVISIBLE LABOR also covers the topic of having a C-section essentially changes the trajectory of one's options for subsequent births. Again, this was news to me. The medical community advises any future births after a C-section also occur via the same method. This is because apparently the incision area is a weak point in the uterus. So doctors want to prevent the very small chance of uterine rupture during labor, which is an emergency situation. Because of that, today doctors often aren't trained on vaginal birth after cesarean (VBAC). Thus, it is incredibly difficult for a pregnant person to find a facility that allows VBACs, essentially forcing them to deliver via C-section even if they want to birth vaginally. The same goes for twin births or the lack of training these days on how to turn a baby in utero to faciliate vaginal births. It seems the default is C-section to spare the hospital a fetal death.

This topic also ties in with the institutionalization of medical care in the U.S. It's basically a business and the goal is to bring in money. C-sections cost more and therefore hospitals receive more money from insurance companies. Never mind that it's major surgery and electronic fetal monitoring (EFM) is unreliable and can result in unnecessary C-sections. (There's another eye-opening chapter on EFM.) The C-section rate in the U.S. is shockingly high--~25-33% of births--and is likely due to several factors. Commodification is one of them, as is race and reliance on technology.

Somerstein also covers how the men infiltrated the midwifery space and how this has far-reaching effects on the level of care pregnant people received. It reduced childbirth to a medical procedure rather than an intimate and supportive community and family event. Care became more about what an instrument could detect rather than what knowledge could impart. It reduced provider-patient connection, which is apparently so important for building trust and emotional support. Moreover, it robbed minorities of their primary way of giving birth, introducing racism into a routine life event. (Somerstein dives deeply into this intersectionality.)

There is so much more I could include in this book review-turned-report, but I'll stop here. If any of the above shocks or interest you, definitely pick up INVISIBLE LABOR. My only quibble is that the delivery of information veers a little more toward a journalistic style. At the same time, it's important to cover all sides of this topic, so that kind of analysis and writing style is par for the course. That said, it's more digestible read one or two chapters per day. Overall, I'm very glad I read this and recommend it to anyone interested in women's healthcare and the intersectionality of that with race and commodification of birth.

Invisible Labor: The Untold Story of the Cesarean Section by Rachel Somerstein is a thought-provoking exploration of the complexities surrounding cesarean births and the often-overlooked contributions of women in this narrative. Somerstein combines personal stories with extensive research, shedding light on the societal and medical factors that influence the perception and experience of cesarean sections. Her insightful analysis challenges conventional views and emphasizes the need for greater awareness and understanding of women's choices in childbirth. This powerful and informative book is essential reading for anyone interested in maternal health and the evolving landscape of reproductive rights.

As a c-s mom, this book was exactly what I needed. Turns out, I had needed it for the past 12 years and I will be recommending it to anyone and everyone who ever struggles with c-s guilt or having been shamed for having had/not having had c-s.

As a mom who has birthed a child via c-section, I was so excited about Invisible Labor by Rachel Somerstein. I am always interested in learning more about the history of the procedure, the risks associated with it, as well as why we've gotten to this point where more and more c-sections are being performed on birthing parents.

With a kindness towards parents and an understanding of the complex feelings around birth and birth complications, Somerstein's Invisible Labor is a must-read for those who have survived this magical and mysterious surgery.

After giving birth to my sickly identical twins I became pro c-section. However, I am well aware of the consequences, as I am living with them. In fact, despite my obvious need for a c-section I had to fight to have one. No amount of medical documentation will work with some doctors, determined to lessen the hospitals c-section stats.
I had an entirely different experience from the author, who had a traumatizing painful birth, like nothing I can even imagine.

I loved this. I love all the information.

Being a mother of two c-sections, I was excited to read this book; however, I was pretty disappointed. I did not finish the book. I was hoping for some true stories and viewpoints on how c-sections are viewed. There was a lot of history in the beginning, and it wasn't in the most compelling delivery. This book may be good for those who enjoy the history part more, but this book just wasn't for me