Diverging from traditional approaches that tend to separate medico-legal histories of obstetrics and maternal health care from socio-cultural analyses of fertility control and maternity, A Miscarriage of Justice expertly draws together the various medical, legal, social and cultural dimensions of reproductive health to develop a highly sophisticated history of women's reproductive lives in early-twentieth-century Rio de Janeiro. It draws on hundreds of primary sources including judicial documents, medical publications, public health data, clinical reports, criminal and civil law, novels, newspapers and photographs to go well beyond its own claim to be the ‘first [study] to explore statistics related to childbirth in a comprehensive manner’ (p. 226). It makes a compelling case for the centrality of reproduction in Brazilian state formation, detailing how women and their reproductive practices became increasingly subject to bureaucratic control by a range of patriarchal state apparatuses, such as medical professionals, law enforcement agencies and the justice system. Nevertheless, challenging the dominant narrative of the medicalisation of midwifery as a battle between male physicians and female midwives, this study also emphasises how the latter remained integral to women's reproductive health as the former recognised the need to work with midwives in order to expand institutional healthcare provision.
This book pivots on poor women's experiences of miscarriage, pregnancy, childbirth (including stillbirths) and fertility control practices such as abortion or infanticide – all of which fall under the rubric ‘reproductive health’ – highlighting how increasing medicalisation of reproductive practices, intense medico-legal debate, and the expansion of mechanisms of patriarchal state control intersected with women's reproductive lives to shape and further reinforce the structural inequities which reproduced racial, gender and class hierarchies that continued to marginalise these women. Cassia Roth's narration of the reproductive lives of dozens of Carioca women amply demonstrates how their fertility and reproductive practices were of increasing public concern, and indeed how they became central to Brazilian nationalism through the valorisation of motherhood for all women, birthing children for the prosperity of the nation. In stark contrast to the forced sterilisations of black women in the United States, Roth traces how the criminalisation of female-led fertility control went hand in hand with the expansion of state surveillance over all aspects of women's reproductive health to lay the foundations for Getúlio Vargas’ federal centralised government in the Estado Novo (1937–45). Embedded in a rhetoric of racial harmony and scientific motherhood, maternity was constructed within a strict paradigm of nationalistic duty (p. 79).
What elevates Roth's argument is the close attention she pays to women's own decision-making, defining reproductive practices as ‘negotiations’ through which women navigated their reproductive lives within the structural constraints that shaped their quotidian experiences. In spite of patriarchal state surveillance of, and intrusion into, their reproductive lives, women consistently sought to maintain a degree of agency over their fertility and maternity in the face of economic and socio-cultural difficulties. Rio de Janeiro underwent rapid change in the early twentieth century: intense European immigration coupled with processes of political transition reconfigured the city's population, and ultimately changed the demographic makeup of poor, fertile women over whom the state claimed reproductive control. Examining the numerous facets of marginalisation poor women faced, be they racial, gendered, xenophobic, economic or social, this study illuminates how state control over reproductive health extended to all women in ways that complicate binaries such as sexual honour/dishonour, Black/White, local/foreign or married/unmarried. Interestingly, there are indications throughout the book that marital status, a factor upon which sexual honour for women so heavily depended, appears to have been of lesser importance in shaping women's reproductive health and outcomes than race, economic standing and social networks, although this is not explicitly stated or explored in depth.
Arranged into seven thematic chapters, A Miscarriage of Justice masterfully builds up a complex historiographical and feminist reading of early-twentieth-century Rio de Janeiro. The opening chapter sets up the medico-legal and political context, delving into scientific, politico-legal ideologies that informed legislative changes and understandings of civil and criminal law to explore how these gave rise to scientific conceptualisations of motherhood alongside developments in racial medicine. The following chapter traces how philanthropic and state-run programmes were implemented in fits and bursts to expand reproductive health services and medicalise birthing practices. After laying out the legal and medical landscape, Chapter 3 makes excellent use of an innovative methodology that positions statistical analysis of birthing in conjunction with qualitative data from criminal sources to reveal how obstetricians’ efforts at institutionalising motherhood and expanding healthcare provision did not materially change women's reproductive experiences during this period. It situates findings within global and national trends, opening up analysis of women's reproductive health on multiple scales of inquiry.
The final four chapters explore how different state mechanisms of control policed women's reproductive practices and the ways these women negotiated constant vigilance and intrusion into their private lives. Roth examines the role of physicians in criminalising fertility control and abortions in particular (Chapter 4), underscores the police force's role as agents of legal medicine through their increasing interventions into criminal and noncriminal reproductive practices (Chapter 6), and emphasises how women's interactions with the judicial system had important implications in defining motherhood, sexual honour and women's rights and citizenship (Chapter 7). Roth persuasively argues that the honour clauses enshrined in law were not the principal mechanism for women to avoid guilty verdicts, revealing instead the primary importance of a gendered legal incapacity that infantilised women and denied them full citizenship or agency. Crucially, Antonio Gramsci's theory of hegemony is also employed to demonstrate that control over women's reproductive lives was not restricted to the state authorities. Chapter 5 complicates the image of top-down state control by navigating how the local community upheld medico-legal ideologies of scientific motherhood through intraclass and female-initiated denunciations of women and their reproductive practices.
The book draws to a close with a highly insightful and thought-provoking conclusion. Beyond a simple recapitulation of the preceding chapters, it considers how medico-legal precepts and women's reproductive experiences in the early twentieth century continue to shape Brazilian women's reproductive lives into the present day. A Miscarriage of Justice is an impressively researched, deeply compassionate patient-centric study that makes important contributions to medical, legal and feminist historiographies of twentieth-century Brazil, whilst also opening up new avenues of inquiry for future scholars to explore through its comprehensive dataset and appendices.
