McGuiness's study of American women religious differs from other recent studies – such as Silvia Evangelisti's work on convent life – in that it highlights the institutional accomplishments of nuns in various fields and integrates those contributions into the wider story of United States history. Catholicism in the American context is highly textured, but one of the strengths of this book is its penetrating analysis of how women religious negotiated their presence there. In the early chapters, McGuiness provides a trans-Atlantic lens to see how the orders of women religious that began in Europe were brought to minister in the United States, what they found when they arrived, and how they refashioned themselves into a powerful agent for social and ecclesial service in the nineteenth and twentieth centuries. Tracking with the waves of immigrants from Catholic nations, McGuiness links religious communities to the populations who sought to preserve vestiges of the homeland through language and culture but who were attentive to the forces of assimilation imposed by America's pluralistic society. Through three major fields of endeavour – education, hospitals and social welfare agencies – nuns in the United States provided stability to newcomers and impressed non-Catholic citizens with their religion's charity and priorities for national advancement. For their trouble, they were often met with violence, unfair taxation and the imposition of state regulation of their institutions. McGuiness draws out those instances where religious sisters functioned creatively to work around these hurdles, which were often compounded by nay-saying bishops. To take a modern example, the birth of the Medical Mission Sisters in 1925 received episcopal approbation, but the order was prohibited from fully flowering owing to a bar on the participation of women in the field of obstetrics and surgery. Only in 1936, with the decree of the Propaganda of the Faith Constans et Sedula, were the Medical Missionaries allowed to perform surgery and other orders dedicated to health care could then meet state standards for training in obstetrics. As once thoroughly familiar with the secondary literature as well as the archival holdings of religious communities around the United States and Europe, the author's resulting study is both engaging and illuminating. Later chapters delve more deeply into the social changes affecting women religious – well beyond the usual references to changes in the habit. Criss-crossing categories of race and class, region and period, McGuiness's book is essential reading for those researching the history of women religious in the United States and should remain a ready guide on the subject for many years to come.