Throughout the twentieth century, Chile pursued reproductive policies that were unique among Latin American countries. Beset by extremely high rates of infant and maternal mortality, Chilean physicians initially blamed mothers for their lack of fitness and intelligence. Chilean policymakers by 1930 embraced the politics of population control advocated by the Rockefellers' International Planned Parenthood group with a vengeance. Not only did Chileans legalise therapeutic abortion in 1931, but physicians allied with the Catholic Church also advocated the use of IUDs, many of which had not been subjected to prior studies and which were inserted without the patient's consent. Only after the 1968 Papal Encyclical denounced all forms of birth control except for the rhythm method did this policy change. Both doctors and clergy maintained this stance to lower the appalling rate of maternal mortality in Chile, although the results initially neither lowered maternal mortality nor infant mortality rates. Thus the country became the model for the international campaigns to prevent a population explosion. Under the Christian Democrats of Eduardo Frei (1964–70), whose administration initially supported Planned Parenthood, Christian orthodoxy won the day and women lost the right to have abortions, often had their IUDs removed without their knowledge, and subsequently lost access to safe abortions.

Pieper Mooney's chilling story, extremely well written and documented with official documents and oral histories of women who had to endure the vagaries of Chilean reproductive politics, offers one of the few histories of government-controlled population policy among a presumably ‘white’ population. She focuses mostly on the period from 1960 onward. When women turned to the Left and to Salvador Allende, a former public health physician, as their supporter, they discovered that he offered continuity of maternal politics rather than change. As with many Latin American leftists, socialist Allende was no friend of feminism, and even though women already had obtained suffrage, their work for Allende bore few practical results. He believed women's place remained in the home.

Under the military regime of Augusto Pinochet that overthrew Allende in 1973, mothers' centres, originally founded to help women in earlier years, turned into a tool of propaganda for right-wing Catholics. Headed by his Pinochet's wife Lucía Hiriart de Pinochet, the centres made no effort to improve the lot of poor women or find solutions to their reproductive dilemmas. Nevertheless, the Pinochet government not only managed to lower maternal mortality but also brought one of the highest rates of infant mortality in the Western world down to manageable rates.

Those leftist women who fled Chile and the wrath of the Pinochet government found new perspectives and methods of organisation during their sojourns in Europe, especially in Germany. This experience enabled them to return to Chile to fight against Pinochet and develop new strategies to counteract the harsh consequences of maternal politics under his regime. And, in an epilogue, Pieper Mooney notes that in 2006 Chile elected its first female president, Michelle de Bachelet, a single mother who had been imprisoned and tortured by the military government.

Although this book is truly provocative and incisive, it leaves a series of unanswered questions. Women's historians have often pointed to the influence of eugenics and the desire to create a future citizenry based upon healthy babies and well-educated mothers. Indeed, most campaigns to lower infant mortality in Latin America, particularly in South America, presumed that mothers needed to be taught and counselled as well as controlled by doctors, and hence a strong French-derived puericultura (scientific child raising) movement evolved and became part of girls' public education experiences. Which eugenics and child-rearing specialists influenced Chileans to turn to such a negative view of mothers? How did policymakers form a cogent argument in favour of abortion? In Chile mothers initially became the enemy, and then ultimately became the victims of poverty and unsanitary living conditions that led to their deaths during or following pregnancy. By limiting pregnancy through the legalisation of abortion and the insertion of contraceptives, mothers' lives were supposed to be saved.

But what about future citizens? How did doctors justify the continued very high infant mortality rates? Did Chile not need workers? Did family planning experts who focused on poor women consciously choose to sacrifice the children of working-class mothers? Did neoliberals under Pinochet understand that they could no longer ignore the mortality rates of children? Although Pieper Mooney notes that Chile focused on the mother–child dyad as an essential component of Chilean society, we know little about what happened to children.

This absence is compounded by a clear lack of statistics that track how legalised abortion reduced maternal mortality, and how the anti-abortion campaign, linked to other strategies, led to Chile's most successful project of the twentieth century in terms of lowering infant mortality rates. Whereas Chilean infant mortality rates ranked as the highest in the modern world in the late 1930s, by the end of the twentieth century the country boasted one of the lowest rates in the world, certainly lower than that of the United States. Chilean officials achieved this reduction through many more policies than simply outlawing abortions, and could have reached these goals much earlier had there not been such a clear anger toward the working-class family. By focusing solely on the abortion issue, the author loses the opportunity to nuance her argument.

Pieper Mooney's emphasis on women who became feminists in exile also obscures the role of feminists who remained and tried to deal with Chile's politics by working from within. Indeed, the attention given to the role of the feminist movement between 1930 and the rise of Allende is preliminary at best. A reader might want to know if Bachelet, who lived for a while in France, worked her way up in politics or used her identity as a former exile to empower her candidacy. Despite these caveats, however, this book is well worth reading.