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Pregnancy, Motherhood, and Choice in Twentieth-Century Arizona by Mary S. Melcher (review)

Mary Melcher examines a host of issues associated with reproduction in Arizona in the last century, including childbirth, midwifery, infant mortality rates, preand post-natal care, contraception, and abortion. She argues that “this vital component of women’s experiences—reproduction and the choices related to it—has been affected by environmental, political, and cultural factors in Arizona and the West during the course of the twentieth century” (178). With respect to environment, for example, birth attendants and caregivers in the state traveled vast expanses to reach patients in rural settings. Consider the difficulty of attending to the health needs of those living in isolated segments of the Navajo Reservation. Roughly 27,000 square miles wide, the reservation spanned over territory in three western states, including much of northeastern Arizona: this remote, expansive space was the challenge of public health nurse Mary Zillatus in the early 1950s. To access this often private world, Melcher included approximately thirty oral histories, memoirs, letters, photos, biographical collections, newspaper articles, and government documents. The result is a thorough examination of women’s health issues over a prolonged and often politically charged period, especially in the postRoe v. Wade era. Beginning with the period 1910–40, the first chapter focuses not only on process (birthing practices and the preponderance of midwifery), but also on differing cultural attitudes towards motherhood and controlling fertility, particularly among American Indians, Mexican Americans, African Americans, and Mormons. Although Melcher employs general terminology to describe the “Arizona women’s experience” (2), her study is mainly centered on the more-marginalized groups listed above. The author notes that “Euro-American families enjoyed greater privileges and public health information” (56); however, she provides little in the way of description or comparative analysis. I suspect this is because Melcher wants to concentrate on those left out of traditional histories. Further, the focus on American Indians and Mexican Americans helps to explain Arizona’s dismal infant mortality rates in the early decades of the twentieth century. In 1922, Arizona’s rate was nearly double the national rate. While the Bureau of Indian Affairs (BIA) was charged with addressing the issue among native populations, the federal Sheppard-Towner Program was tasked with improving birth rates among Mexican Americans. Unfortunately, the program failed to effectually provide services to the state’s largest minority group by not properly staffing or providing proper training to midwives. During the New Deal, the federal government provided further medical outreach to those living in remote migratory camps through the Farm Security Administration. Access to contraception expanded dramatically when Margaret Sanger—the face of the American birth control movement—moved to Arizona in the early 1930s. Sanger amassed a team of local volunteers, including Peggy Goldwater (wife to future senator, Barry Goldwater), to establish Planned Parenthood clinics in Tucson and Phoenix. Impeding the adoption of family planning practices among minority populations was both physical distance and cultural biases against 2014 Book Reviews 445