One of the enduring quandaries of the Caribbean region's demographic history has been how the small island of Barbados was able to successfully reproduce its enslaved population by the end of slavery in 1834, when almost every other sugar-producing territory in the region experienced a natural decrease in the slave population in the same period. Katherine Paugh's recent contribution to the scholarship provides an analysis of race, medicine, and fertility in what is termed as the Age of Abolition, roughly a period spanning from 1790 to 1834. Paugh traces connections between abolitionist fervor in Britain and the pro-slavery lobby in both Britain and the Caribbean to the management of enslaved women's health and reproduction.

The book is organized into six chapters providing windows into several perspectives about the debates surrounding enslaved women's bodies, including fertility. In the first chapter Paugh places the discussion of enslaved women's fertility and reproduction within the context of the geopolitical forces, such as the American Revolutionary War and the Haitian Revolution, which as Paugh argues, defined the gradualist approach to the abolition of the slave trade and slavery.

In the second chapter she introduces the multigenerational liberation struggle of a female-headed enslaved family in Barbados through the case of Mary Hylas, who was the mother of Old Doll and Mary Ann Saer on Newton plantation in Christ Church, Barbados. Paugh examines the case that Mary Hylas's husband, John Hylas, brought against her owner, John Newton, in 1768. John Hylas alleged that his wife's owner kidnapped her when the Newton family decided to return to Barbados in 1766. The case is a little known precedent to the Somerset v. Stewart case (1772), which established that chattel slavery was contrary to common law in England and Wales and therefore could not be supported once enslaved Africans set foot in England and Wales. Paugh's use of the case underscores her analysis of the precarious nature of enslaved/free women's rights as defined by law in the metropole and the colony. She also examines the subsequent sexual liaisons that Mary Hylas and her daughters had with white men to discuss how interracial relationships challenged the moral order of plantation society, which often conflicted with the growing Christian missionary zeal that accompanied abolitionism in Britain and its Caribbean colonies.

In the third chapter, Paugh explores how medical practitioners and planters who were writing about the care and management of slaves perceived enslaved women's fertility, sexuality, and reproduction. She discusses the interactions between enslaved patients and their European doctors and the subsequent publication of these interventions, which contributed to the development and circulation of medical knowledge about enslaved bodies in the late eighteenth to early nineteenth centuries.

Paugh continues her focus on the Newton plantation records and especially the lives of Old Doll's family members in chapter 4. She discusses the politics of childbirth and midwifery in Barbados, while extending her analysis to the wider British Caribbean. Again, she emphasizes the role that pro-natalist policies played in the motivations of Caribbean midwives to practice their craft.

In chapter 5 she examines Malthusian debates surrounding abolitionism and its impact on slave demography in the Caribbean. It is a constructive discussion about the connections between emerging population science and the amelioration process. Paugh makes some useful connections between imperial debates about slave registration legislation (which was an imperial attempt to register the number of enslaved Africans in each of its colonies) and the outbreak of the 1816 Rebellion in Barbados, which Barbadian planters blamed for fomenting unrest among enslaved workers who believed the measure would lead to their emancipation.

In chapter 6 Paugh looks at examples of free colored women who helped to shape the response of Caribbean women to abolitionism and the Christian missionary movements that increasingly influenced sexual politics in the region. Paugh uses the sermons and correspondence from the climax of local planter persecution of Methodists, especially Reverend Shrewsbury and Sarah Ann Gill, and Methodism's advocacy of Christian marriage for enslaved converts. She examines the inherent hypocrisy of local sexual and reproductive politics and the challenges this posed to discussions about fertility and reproducing the enslaved workforce.

Although Paugh delivers convincing testimony linking fertility discourse to abolitionist and pro-slavery movements through Barbadian examples, she could provide context for the much larger regional reality of low fertility, high infant mortality, and the perpetual decline of the slave population in the British Caribbean by 1834. The Barbadian case is certainly an outlier in the region's demographic history of the slave trade and slavery, exposing some challenging truths about the effectiveness of abolitionist propaganda in the age of abolition and its accompanying counter-narratives from the pro-slavery lobby which sought to promote the natural increase of the slave population with little success in the rest of the region. Proclaimed pro-natalist policies in both the metropole and the colony had little effect on the low birth rate and the high infant mortality on the region's plantations. However, her analysis of the increasing state intervention into the sexual and reproductive lives of enslaved women, and later, free colonial subjects provides valuable insights for researchers.

Paugh's investigation of enslaved women's fertility, which is largely drawn from sources privileging the white dominant male voice in both abolitionist tracts and planter management manuals, could also consider the influence of African culture on slave reproduction. Although Barbados could be said to be largely a Creole society by the 1790s, this does not obfuscate the role that African perceptions about fertility and its control played in reproduction, particularly in terms of how enslaved women viewed their bodies and pregnancy as well as how enslaved and free colored women engaged in midwifery practice. There is good evidence from across the region that enslaved women continued to entrust their care to practitioners of largely African-derived medical systems of knowledge.

The Politics of Reproduction provides further insights into the debates about enslaved women's bodies and reproduction in both imperial politics as well as on the ground in British Caribbean slave societies.