Invisible Labor

An incisive yet personal look at the science and history of the most common surgery performed in America—the cesarean section—and an exposé on the disturbing state of maternal medical care

When Rachel Somerstein had an unplanned C-section with her first child, the experience was anything but “routine.” A series of errors by her clinicians led to a real-life nightmare: surgery without anesthesia. The ensuing mental and physical complications left her traumatized and searching for answers about how things could have gone so wrong.

In the United States, one in three babies is born via C-section, a rate that has grown exponentially over the past fifty years. And while in most cases the procedure is safe, it is not without significant, sometimes life-changing consequences, many of which affect people of color disproportionately. With C-sections all but invisible in popular culture and pregnancy guides, new mothers are often left to navigate these obstacles on their own.

Somerstein weaves personal narrative and investigative journalism with medical, social, and cultural history to reveal the operation’s surprising evolution, from its early practice on enslaved women to its excessive promotion by modern medical practitioners. She uncovers the current-day failures of the medical system, showing how pregnant women's agency is regularly disregarded by providers who, motivated by fear of litigation or a hospital’s commitment to efficiency, make far-reaching and deeply personal decisions on behalf of their patients. She also examines what prevailing maternal and medical attitudes toward C-sections tell us about American culture.

Invisible Labor lifts the veil on C-sections so that people can make choices about pregnancy and surgical birth with greater knowledge of the risks, benefits, and alternatives, with information on topics including:

• VBAC (vaginal birth after cesarean) and repeat c-section
• Pain and pain management during childbirth
• How C-sections can affect family planning
• The valuable role of midwives and doulas in the birth experience
• The myths behind “natural” childbirth
• How limitations put on reproductive rights impact pregnant people

With deep feeling and authority, Somerstein offers support to others who have had difficult or traumatic birth experiences, as well as hope for new forms of reproductive justice.

Rachel Somerstein is an associate professor of journalism at SUNY New Paltz. She has written for the Washington Post, Guernica, and Wired, among many other publications. Invisible Labor is her first book. She lives in the Hudson Valley with her family.

“A decade after my first C-section, Invisible Labor helped me process wounds I thought were healed. Rachel Somerstein looks directly into our bodies and body politic, revealing the gender and racial power dynamics that make the C-section America’s most common surgery. Rigorously and lovingly reported, Invisible Labor is a gift, both long overdue and right on time.” — Angela Garbes, author of Like a Mother and Essential Labor

“Somerstein lifts the surgical drape on the cesarean and explores what it really is, what it has meant for mothers, and how it has been weaponized. The operation affects women most deeply, physically and psychologically, but it ripples out in ways that the ever-expanding literature on modern maternity care has not fully examined and that belie the hidden bikini scar. With fascinating medical history, trenchant cultural analysis, and unflinching personal testimony, Invisible Labor is an important, accessible contribution.” — Jennifer Block, journalist and author of Everything Below the Waist and Pushed

“Rachel Somerstein’s Invisible Labor is astonishing for parents—like me—who never even thought to ask questions about the most important experience of their lives. She has done that rare thing that the very best books do: she has made the unseen seen. And if there’s any justice in this world, this book will change systems.”
— Rachel Louise Snyder, author of Women We Buried, Women We Burned and No Visible Bruises

"In Invisible Labor, Somerstein uses the C-section to illuminate how broad social issues surrounding reproductive health—from our financialized medical system to inequitable access, from racism to the dismissal of women's pain—shape pregnancy, labor, and birth in ways both small and large. At once vulnerable and incisive, this is a stunning and necessary read." — Deborah Copaken, author of Ladyparts

“A sharp account of an agonizing experience of childbirth. . . . The author’s anger over that traumatic experience infuses her investigation of the medical, social, and cultural history of C-sections and, more broadly, of a medical system that denies pregnant women’s autonomy and discredits or ignores women’s pain. . . . [Somerstein] draws on considerable research. . . . A hard-hitting critique of a persistent problem.” — Kirkus Reviews

“[E]xcellent . . . .The damning history highlights how sexism and racism have shaped women’s healthcare for centuries. . . .This is a must-read.” — Publishers Weekly (starred review)

“A sobering and deeply interesting look at the history of and debate around C-sections. . . . A provocative and well-researched book. . . . Invisible Labor also makes clear that we still have a long way to go in adequately supporting women’s health, and therefore, it is of value to us all.” — BookPage

“[Somerstein’s] expertise as a journalist shines . . . . [A] superb book . . . . persuasive and riveting.” — Science 

“This inciting, empowering book shows the clear need not just to improve women’s access to health care but also to shift the paradigm about the restrictions placed on reproductive rights.” — Library Journal (starred review)

“A thorough investigation of birthing practices grounded in misogyny, racism, and other forces contrary to the well-being of mothers. . . . Invisible Labor clearly and compassionately blends scientific research and reportage with the personal stories of Somerstein and other women. Childbirth is painful, but with the right care, it can also ground us in our humanity.” — Los Angeles Times

“Invisible Labor makes a compelling case for how the C-section’s widespread application in the U.S. reveals troubling patterns across our reproductive-health system—some of which trace back to slavery and eugenics. . . . a testament to the transformative potential of respecting women as authorities on their own bodies.” — Atlantic 

"Somerstein presents a fuller picture of how and why C-sections have come to be the way one-third of Americans are born, takes on the medicalization of childbirth and sheds light on the risks and consequences of the surgery so people can make informed choices." — Times Union

"Somerstein’s own experience informs and colors her book, but her important exploration into surgical birth goes well beyond the personal. Examining everything from the history of obstetrics to the financialization of health care to the way individualism impacts both our ideals and experiences of childbirth, Invisible Labor truly gets at the multiverse of factors that make up cesarean birth in the United States. C-sections are individual and systemic, a birth and a surgery, a monumental life experience and a common medical procedure." — Rewire

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