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Monstrous Conceptions
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07 July 2026

In the nineteenth century, American medical practitioners helped craft a new science of monsters. The term “monstrous birth” had long been applied to newborns with congenital conditions such as anencephaly. When practitioners redefined “monstrosity” in scientific terms, they claimed to be stripping away its fraught connotations. Instead, recast as a biological phenomenon, the monster gained new social and cultural salience. Monstrosity gave form to pervasive ideas about the meaning of racial difference, the fragility of racial order, and the peril of racial degeneration.
Miriam Rich explores the history of monstrosity as a modern scientific category, tracing the practices that transformed newborn bodies into medical specimens across the nineteenth- and early twentieth-century United States. Monstrous Conceptions vividly examines experiences of pregnancy, birth, and postpartum care; the preparation and display of anatomical specimens; and the production and circulation of scientific knowledge. It shows how diverse laywomen and their families engaged with medical meaning making even as predominantly white, male practitioners increasingly sought to assert authority over reproduction. Rich also reveals how the nineteenth-century category of biological monstrosity helped lay the groundwork for the American eugenics movement—and contributed to ideas about deviant and defective bodies that still haunt us today. Shedding new light on intertwined historical conceptions of race, sex, and disability, Monstrous Conceptions illuminates how medical science produced enduring notions of human difference.
— Sharla M. Fett, author of Working Cures: Healing, Health, and Power on Southern Slave Plantations
With exquisite prose and exhaustive research, this poignant study illuminates how ideas about race, sex, and disability shaped the medical category of monstrosity. Vividly rendered, Monstrous Conceptions stands out for its deft navigation of fraught ideas and for its perceptive, and even visionary, theorizations of the reproductive body and its offspring.
— Elizabeth O'Brien, author of Surgery and Salvation: The Roots of Reproductive Injustice in Mexico, 1770–1940
This is a brilliant piece of scholarship that is critically needed, especially as we grapple with issues of conception, reproductive justice, disability rights, and biomedical ethics in a post–Roe v. Wade United States.
— Deirdre Cooper Owens, author of Medical Bondage: Race, Gender, and the Origins of American Gynecology
Preface: A Note on Terminology and Images
Introduction
1. Monstrous Pregnancies: Women’s Narratives and Medical Knowledge Making
2. Monstrous Newborns: Emotions, Embodiment, and Sensory Relation
3. Monstrous Specimens: Material Cultures of Collection and Display
4. Monstrous Images: Medical Illustration and Photography
5. Monstrous Logics: Concepts of Race, Sex, and Disability
6. Monstrous Legacies: Eugenic Afterlives of Monstrosity
Epilogue
Acknowledgments
Notes
Bibliography
Index