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Birth in Times of Despair
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29 October 2024

Winner, 2025 Council on Anthropology & Reproduction Book Award
Explores forms of maternal harm stemming from US policies on the US-Mexico border
In El Paso, Texas, the racist undertones of anti-immigrant sentiment have contributed to various forms of violence in the region, including the 2019 mass shooting that was the deadliest attack on Latinos in US history. As the community continued to mourn this tragedy, the COVID-19 pandemic unleashed yet another set of economic, social, and public health catastrophes that were disproportionately felt within the border region.
In Birth in Times of Despair, Carina Heckert traces women’s emotional experiences of pregnancy, birth, and the postpartum period in the midst of a series of longstanding and ongoing crises in the US-Mexico border region. Drawing from interviews, surveys, and medical records of women who gave birth during an intense period of sociopolitical crisis, she examines how limited access to health care, inhumane immigration policies, and exposure to an array of harmful social environmental circumstances serve as sources of intense harm for pregnant and recently pregnant women. In so doing, Heckert reveals how these experiences serve as a profound critique of policies that continue to fail to protect women and their families. She concludes with suggestions for practical, humane, and urgent policy changes to alleviate the needless suffering of this vulnerable group.
With its comprehensive portrait of the abysmal physical and mental health outcomes pregnant women face within the border region, Birth in Times of Despair expands our understanding of how obstetric violence is enhanced by the structural violence of the state, and unveils the urgency to ameliorate the harm caused by current immigration policies.
— Heide Castañeda, author of Borders of Belonging: Struggle and Solidarity in Mixed-Status Immigrant Families
Carina Heckert has written a major book which illustrates how the configuration of dehumanizing policies puts the lives of pregnant women in great peril in El Paso. Lamentably, we hear women describe how the conditions they face place restrictions on the mothers they desire to be. This book is a must-read for students, researchers, practitioners, and policymakers who need to know the pernicious consequences of mean-spirited policies against women, immigrants, and people of color.
— Rogelio Sáenz, University of Texas at San Antonio
Birth in Times of Despair is about a deep, pervasive – and largely invisible – maternal health crisis facing women of color living on the southwest border where the effects of policy, pollution, and social stressors upon a community are exacerbated – particularly for those whose pregnancies occur in dark times.
Heckert's interdisciplinary project examines the pregnancy, birth, and postpartum experiences of Latina women living in the US border city of El Paso, Texas, interrogating how reproductive violence—including legal, symbolic, and structural violence—causes maternal harm.
Carina Heckert is Associate Professor in the Department of Sociology and Anthropology at The University of Texas at El Paso and author of
Fault Lines of Care: Gender, HIV, and Global Health in Bolivia.