Medicalized Motherhood: Perspectives from the Lives of African-American and Jewish Women.

Reichman, Nancy

Medicalized Motherhood: Perspectives from the Lives of African-American and Jewish Women. By Jacquelyn S. Litt. New Brunswick: Rutgers University Press, 2000. xi + 189 pp.

Dr. Benjamin Spock's influential Baby and Child Care, published in 1946, is often regarded as a tour de force for medicalized mothering, a scientific approach to housekeeping, feeding, and baby care that emerged in the early twentieth century. Consistent with other progressive-era policies, pediatricians, women's magazines, government pamphlets, as well as visiting nurses, began to advocate for scientific motherhood, practices that would enable minority and immigrant women to become "fit" and respectable [white] Americans. Admonishments to "fight segregation ... with soap" suggested that "mundane matters of child feeding, hygiene practices, housekeeping, dress, and so on were deeply significant for the fight against racism and segregation" (31).

Litt interviewed Jewish and African American women who were mothers in Philadelphia during the 1930s and 1940s to learn how they experienced and made use of this emerging medical discourse. These two groups were among the implicit, if not explicit, marginalized "others" that were the targets of such Americanization campaigns. Their thick descriptions of everyday household child-rearing practices, Litt suggests, will help us better understand the development of medical authority in the first half of the twentieth century. Her analysis of these women's narratives reveals multiple and contradictory meanings of medical discourse, depending on the ethnoracial and social position of the narrator. These differences "show medical discourse not as a culturally neutral set of technical practices but as a site where social movement and inclusion for some and cultural dislocation and exclusion for others is enacted" (40).

Eighteen of the mothers interviewed by Litt were Jewish. Fifteen of these were daughters of immigrants; three were immigrants themselves. Litt's analysis demonstrates that Jewish women tended to seek out medical expertise for the purpose of social mobility, i.e. to become socially mainstream. The narratives of the second-generation Jewish women were infused with the distinction between that which was "old fashioned" and "what we do today" (55). Medicalization for many of them became an obligation. "You had to go" to the doctor's office to weigh your baby if you wanted to be a good mother. In another example of obligation, a mother attracted to baby magazines counseled others to throw them away lest they fall out of favor with the visiting physician.

In contrast to the Jewish women who experienced medicalized motherhood as a route to social advancement, many of the twenty African American women spoke in terms of social isolation and alienation. Although the backgrounds of the African American women were more diverse than the Jewish sample, they shared skepticism, if not fear, of the new medical practices. Instead, their narratives detail the advantages of traditional methods of caretaking and remedy of the South, where these women were born. "Segregated from the medical establishment, many African-American women developed mothering practices grounded in their local knowledge and traditions. "You don't need no teachin' on it" (87), one woman commented.

Litt locates the experiences of these women in their larger social networks. Jewish women were part of socially homogeneous, upwardly mobile communities that included physicians advocating a more scientific approach to motherhood. Thus, she suggests, medicalized motherhood was attractive to Jewish women because it was integrated into the everyday relations of life as a socially unambiguous route to modernization and mobility. Confronting a racist profession, upper-class African Americans established formal network ties with African American professionals who could help secure access to middle-class institutions for their children. Medicalized motherhood was attractive to them as it operated in support of actors and institutions who they thought would be agents of social change. Poor African American women forged ties to medical institutions without the support of either the informal and formal networks of other mothers. Instead, they encountered medical discourse in the homes of their domestic employers, in the doctors' offices in which they worked, and other places of marginalized social identity. Consequently, they remained marginal to dominant medical discourse and practice.

Medicalized Motherhood is an important entry into a growing body of work that uses the experiences of everyday life to document and understand ethnoracial and social class divisions among women. Litt does a good job of demonstrating how the medicalization of motherhood in its everyday practice reflects and reproduces those divisions.

Some cautionary notes to the analysis are in order. The sample is small, drawn through a combination of convenience and snowballing techniques. This is not necessarily a negative, but it limits the ability to control variables that might better isolate the effects of race and class that are central to the analysis. Would the analysis be the same if a more diverse group of Jewish women were interviewed, or if the Jewish and African American sample were purposively matched in some way? And although one hesitates to critique a book for what it is not (i.e. the book I would have written), I wondered how immigration status (first generation, second generation) intersects with ethnicity, race, and social class in the analysis. Immigration, and the networks that develop around it, seemed to be an implicit theme in many of the narratives, especially among African Americans who migrated from the South to the North, yet "generation" remains unexplored as a variable in the analysis. Similarly, there is no discussion of antisemitism, clearly an important sociological fact of the time, but surprisingly absent in the narratives themselves--an omission that bears some reflection given the concerns of the book. To what extent might such omissions reflect the fact that women are providing narratives of events that occurred fifty or more years ago and that are now refracted through the experience of more current events? Indeed, what can one say, or should one say, about the plausibility of relying on memory to construct an assessment of everyday practices? How might current events frame our memories of the past? Finally, I was surprised to learn so little about the women who were the subject of the book, nor much about the larger social context of their lives. More consistent context would enable us to better assess Litt's use of the narrative fragments and her interpretations of them. Historians, I suspect, will want more.

Notwithstanding these critical comments, the book is impressive. It is well written and accessible. It neatly demonstrates more complicated theoretical points about identity, networks, stratification, agency, and women's complex relationship to objectified discourse. The book includes a "must read" discussion about how ethnoracial and class differences between researcher and respondent affect both the interview and interpretation. All in all, a sound contribution.

Nancy Reichman

University of Denver