Managing Reproductive Life, an edited volume with 12 chapters by specialists in anthropology, gender, child development, and international health, explores women’s reproductive strategies in the context of global trends such as migration, war, and refugee displacement. The volume is organized on the premise that health policies may be of little value without attention to the cultural context of reproduction and to women’s agency.

Although the introduction overstates the widely accepted argument that scholars need to move beyond a narrow perspective that limits reproduction to the biological and that neglects the broader social, economic, and political contexts shaping reproductive behavior, the authors provide innovative ethnographic data and analysis organized around three principal themes: agency and identity, fertility and parenthood, and policy and vulnerable groups.

In her excellent chapter on Rajasthani women, Kumar argues convincingly that women’s reproductive decisions can best be understood by means of the motivations underlying women’s use of reproductive health services. She explores the emotional dimensions of women’s lives and details how spousal affection, notions of responsibility, and the developmental cycle of the family ultimately shape reproductive strategies.

Using ethnographic data from Bolivia, Hawkins and Price critique demographic and health policies that fail to account for how sexual and reproductive health are constituted within particular cultural and economic contexts. Attention to everyday practices of migrant women, including the role of emotion in shaping women’s decisions, leads the authors to conclude that a “neoliberal” and biomedical construction of the autonomous individual fails to explain women’s reproductive health strategies. Effective health policies will require broader approaches that address women’s overall lack of empowerment.

Both Montgomery and Day address aspects of reproductive health among sex workers and explore health risks, STDs, and the meaning of motherhood for their informants. Montgomery provides unusual ethnographic detail on child prostitutes in Thailand, pointing to the lack of local-level research on fertility and reproductive health, as well as on the fundamental causes of child prostitution. Day identifies the tension between the public and private lives of London sex workers, for whom the desire for motherhood is juxtaposed with frequent pregnancy terminations and associated risks of infertility.

Hampshire applies demographic and anthropological approaches to analyze fertility decisions and outcomes among Fulani in northern Burkina Faso. Her research cautions against making overly simplistic inferences from correlations between migration and fertility decline. She suggests that social changes anticipated with “modernization,” such as increased autonomy for women leading to reduced fertility, are less significant in the Fulani case than an unwanted increase in sterility, probably linked to STDs.

Belaunde similarly critiques demographic assumptions regarding natural and controlled fertility in her study of menstruation, birth, and couples’ relationships among the Airo-Pai of Amazonian Peru. She advocates a shift from a female to a couple-centered approach and links fertility with the culturally constructed expression of emotions between a couple and toward children. This case effectively illustrates that in contrast to demographic transition theory, integration into national society may imply abandonment of fertility regulation rather than increasing agency in women’s fertility decisions.

In her chapter on coping with infertility in Nigeria, Cornwall offers both a perspective on children’s “agency” in creating ties with foster mothers and poignant reflections on the meaning of infertility in a strongly pronatalist society. She suggests casting reproduction less as “a patterned set of choices than as a contingent process over time” (p. 155). Her case histories document how relations of mothering are produced and renegotiated, enabling some infertile women to assume the social role and identity of “mother.”

Similarly, Martin explores the meaning of children to parents in Hong Kong and contends that although children are valued for their potential economic and ritual contributions, the Chinese family is parent-centered. In spite of changes in family structure and a decline in fertility, filial piety remains idealized, and Western psychological traditions of intensive parenting appear to have had little impact.

As the opening chapter in the section devoted to policy issues, Boyden’s review of scientific conceptualizations of childhood and youth is less ethnographic than theoretical. She offers historical and cross-disciplinary perspectives on human development and critiques models of childhood that fail to account for individual agency, thus diverting attention from “the social and moral competencies” of children and adolescents (p. 179). Price and Hawkins’s subsequent chapter emphasizes the need for increased attention to sexual and reproductive health needs of youth. They review existing policies and programs in poor countries, recommend approaches to sex and reproductive health programs that are multidimensional and locally relevant, and document precisely which projects “work.”

Using case studies, Russell links macro- and microlevel perspectives on teen pregnancy in Teesside, U.K., and vividly details examples of personal decisions regarding sexuality that are often obscured in statistics. This chapter provides a particularly astute exploration of teenage sexual behavior and its public construction as a moral and social problem. Harris and Smyth conclude the policy discussion with a strong statement on refugee health issues that identifies structural constraints preventing the effective implementation of policies. They suggest that reproductive health cannot be separated from conditions of poverty, gender-based power relations, and “health” more broadly construed. They join numerous anthropologists in arguing that it is imperative to engage local populations in developing culturally relevant reproductive-health interventions.

This edited volume is notable for its coherence and the consistent attention to the themes of the three sections. One regrettable feature is the lack of reference to much of the anthropological literature on reproduction and child health published in the United States, which would have bolstered the volume editor’s introductory argument for the centrality of reproduction to anthropological theory. The book is most likely to interest scholars in medical anthropology, gender issues, and international health policy. It would be appropriate for advanced medical anthropology courses as well as specialized classes on international health, reproduction, or sexuality.