Abstract
The reproduction of inequality is a well-written and clearly organized book that examines the sociology of human reproduction and the social pressures that women encounter regarding pregnancy, birth, and the post-partum period. This book is written at an advanced level and would be appropriate as a text in upper-level undergraduate and graduate-level courses and would appeal to faculty and professionals seeking specialized knowledge in this focus area. The vocabulary in this book would be challenging to anyone who had not been exposed previously to sociology, social work, or feminist theory.
The author interviewed 70 cisgender women in California and Florida who described themselves as “mothers.” The subjects were categorized into four primary groupings defined by high versus low educational status and high versus low socio-economic status. The HH group members attained a 4-year college degree or higher and were designated as a member of the high-income group because they were not eligible for WIC, a federally funded nutrition program for Women, Infants and Children; the LL group did not have college degrees and were eligible for WIC services; and there were two mixed groups, the HL and the LH that were also categorized based on educational status and income. The HL group was typified by graduate students who were highly educated, but, because of their current educational demands, were not income-producing, and the LH group was exemplified by women on an upward socio-economic trajectory, such as women who were the first generation in their families to access college or become business owners. Throughout the book, the author compared and contrasted responses from the HH and LL groups and provided discussion regarding their experiences and perceptions. The mixed status groups were useful in providing insights into the origin of the cultural norms the women described. Was the norm or perception a result of education or economic status? The author also analyzed and discussed the responses by age, race, marital status, and social mobility.
The book delves into an analysis and discussion of responses to survey questions the author asked the women about their experiences and perceptions during pregnancy, birth, and post-partum period regarding their own health and the responsibility for their children's health. In the analysis, the book describes reproductive body projects, which are the practices and activities that women undertake to care for themselves and, ultimately, have a healthy pregnancy, birth, and child. It describes body care choices such as breastfeeding, nutritional choices, and exercise as well as eating disorders, sexualization of their bodies, co-sleeping, and the use of drugs or alcohol.
The book also describes the interactions women had with healthcare providers, social service agencies, such as WIC, and community, peer-support organizations, such as La Leche League. For example, HH mothers tended to have horizontal relationships with healthcare providers, where the mothers possessed significant knowledge, asserted their social status as an equal (not subordinate), and requested personalized feedback regarding healthcare decisions. The author described this relationship as a middle-class entitlement where parents not only required personalized care but modeled this interactional behavior for their children who would learn and, later, as adults, repeat this behavior. However, LL mothers had vertical relationships with healthcare providers, who were seen as authority figures who provided the socially subordinate LL mothers generalized feedback that might not have been sufficiently personalized to assist them with their healthcare challenges.
An important theme throughout the book is the influence that the risk avoidant paradigm and the risk assessing paradigm have on women of different socio-economic statuses. For example, the risk avoidant paradigm indicates that there is no cost too high nor sacrifice that is too great to ensure the health and well-being of the child. While theoretically valuable, many women cannot afford the time, financial, or other resources necessary in the risk avoidant approach, so they use the risk assessing approach to determine the best way to use limited resources. While all women interviewed stated that some risk avoidant costs were too high in terms of time, financial resources or comfort, their experiences were quite different. Perhaps because of their upper- and middle-class status and interaction with healthcare providers as peers, HH women described being given permission by healthcare professionals to relax or modify the rules to meet their personal situation. On the other hand, while having fewer financial resources, LL women, being in a subordinate position to healthcare providers, found it more challenging than did HH women to communicate their needs in a way that would be perceived as legitimate and have them addressed in an individualized manner that would meet women's needs and the needs of their children. Additionally, LL women were more likely to be labeled as “bad mothers,” prosecuted for child endangerment, or lose custody if they didn’t comply with risk avoidant norms.
Describing the reproductive body projects, the author summarizes the overall theme of the book by stating, “Explicitly, the goal of these projects is to optimize the biological processes of human reproduction, resulting in healthy children. Implicitly, as this book shows, these projects facilitate the long-term process of social reproduction, which makes it likely that children will inherit not only their parents’ genes but their social class and culture as well” (p. 27).
