Abstract
In Babylost: Racism, Survival, and The Quiet Politics of Infant Mortality, from A To Z, Monica J. Casper takes an innovative approach to put in both historical and sociological context the shameful tragedy (c.f. Jones 2016) of infant mortality in the United States. She uses the alphabet to organize the factors that contribute to preventable infant mortality that can be divided into clinical, political, social, theoretical, and actual categories, and this method allows for readers to grasp both the entirety and the simplicity of what is necessary to stop babies from dying. Additionally, she achieves the difficult task of tackling the hard reality that not all infant deaths are preventable and yet still pushes us to think about the families that experience these losses. It is an effective approach that is filled with tangible suggestions and solutions.
Full disclosure: My work is cited and I am named in the book, so it is not lost on me that I read and am reviewing this book after the Dobbs v. Jackson Women's Health Organization decision overturning Roe v. Wade in the United States. Ironically, the Supreme Court of the United States will hear a case this term that specifically addresses the legal aspects of fetal personhood. Therefore, it is particularly profound for me—as a scholar who works across the reproductive spectrum and whose attention is needed on acute problems such as the intersection of the Black maternal health crisis and draconian abortion restrictions—to be addressing infant mortality, a problem that has been documented for decades. That said, these concepts are closely related, and I will use my review of Casper's book to show the brilliance of her approach and how it adds to analytic frames that have been historically siloed. She provides a deeply researched book with rich references that allow transdisciplinary scholars to connect some dots that perhaps for others may be blocked because of disciplinary perspectives—yet another gift from sociologists.
Black feminists and other scholars have proposed reproductive justice as an antidote, strategy, theory, and organizing frame to drive and guide action (Ross and Solinger 2017). Given that the tenets of reproductive justice are outlined in the book and briefly summarized as the right to have children, to not have children, and to parent children that families already have in safe and sustainable environments, to understand Babylost as a book that is not championing reproductive justice would be a mistake. First, even though the words “social safety net” appear nowhere in the book, there are implicit examples throughout Casper's writing that suggest that a more robust social safety net would result in reductions of infant mortality. This is also borne out by evidence that she cites. Similarly, the need for human services to align with health—that is, Health and Human Services—is clear and obvious if we are to act in face of need.
Second, Casper masterfully intertwines multiple domains of science, aligning the humanities with the clinical and health services provision literatures, and makes a subtle case for the need to re’legitimize the humanities as a foundation for the practice of nursing, medicine, and other disciplines in the health professions. Third, Casper highlights divestment and mistreatment as factors that could be rapidly targeted to address the shameful inequities that are shown in infant mortality. It requires moral courage to name a problem, suggest a solution, and to act—even when it is unpopular—toward prevention strategies that are known to work in less’resourced areas. This is a lesson that has implications far beyond infant mortality and has been exacerbated by the COVID-19 pandemic.
However, the thing that struck me most about Babylost is that it is not an academic book per se. It can be easily read by the public, by someone with lived experiences, or by clinicians, and it is filled with data that are both accessible and contextualized. It would be completely irresponsible not to also mention that intersectionality is apparent in the book even though one might think that would be eliminated by the alphabetical nature of the organization of the content. In fact, the book is cross referenced, and personal stories, anecdotes, photos, and quotes are interspersed throughout so that it reads as a cogent narrative, despite the fact that it can be read by each letter of the alphabet and have the content stand on its own.
Despite the complexity and multi’factorial causes of infant mortality, I finished reading Casper's work feeling activated and refreshed to continue the important work of safely propagating our species and supporting the people courageous enough to venture on the journey to parenthood regardless of pregnancy outcomes. Because inherently embedded in Casper's work is the notion that regardless of race, ethnicity, religiosity, spiritualism, creed, sexual, gender or other orientation/identity, a society that is unable to shepherd its newest citizens to this plane and protect them in their first years of life should alarm us all and should require the attention of everyone. If “the arc of moral justice is long, but bends toward justice,” as Martin Luther King stated, then we need to decide where on that trajectory we can act and then do so. The calls to action as well as the summary of historical data in Babylost should motivate us all to act in the face of need.