I picked up this book on the recommendation of Modern Mrs. Darcy, and I wasn’t disappointed. It’s a moving story of a young black nurse in the 1970s, about a real-life class action suit to address the coerced or forced sterilizations of young women of color in hospitals and institutions across the United States.
Civil is a young black woman, just out of college with a nursing degree in Montgomery, Alabama in 1973. Her parents are both educated and she’s never experienced the poverty that many black families are living in, until she begins working in a family planning clinic. She’s assigned two sisters, 11 and 13 years old, who are on monthly Depo-Provera (birth control) shots, even though neither are sexually active and the younger hasn’t even had her period yet. When Civil learns that Depo-Provera isn’t FDA-approved and may put women at a higher risk for cancer, she’s concerned about the values of the clinic. As she tries to figure out the right thing to do for this family, she becomes more and more emotionally involved, resulting in devastating consequences for the two young girls.
Civil learns that, while this is the same year the Supreme Court passes Roe v. Wade, poor women of color around the country have been forced into sterilization. Some of them are in institutions, others are reliant on social services and benefits, and some women have even been forced to consent to sterilization while in labor.
This book is a fascinating legal and political history of the case of Relf v. Weinberger, brought by the Southern Poverty Law Center in 1973. I loved the way the author portrayed the shifting legal strategies and the way legal justice in the courts intersects with political activism, and even the role federal agencies can play in either promoting or ending serious injustices. I appreciated the author’s attention to detail; the book even includes hearings before Congress and an interview with Senator Ted Kennedy. Seeing the Capitol through Civil’s eyes really brought it to life.
It’s also a story of Civil’s personal growth. I really liked the way the author had her wrestle with difficult issues. Civil wants to help this family, but learns that “help” can be condescending or controlling, and that these girls, and their family, are more than just her clients or people to be taken care of. I also appreciated the nuance of Civil wrestling with her own privilege, even as a young black woman. There are many layers of injustice in this story, regarding the medical treatment of women, people of color (the book references the Tuskegee syphilis experiment), those in poverty, and those in institutions or dependent on the government. Finally, Civil has to contend with her own feelings about motherhood and abortion.
We see this story through Civil’s eyes as an older woman. I don’t always love the plot device of telling a story in two different times, and maybe it wasn’t entirely necessary here, but it was interesting to see Civil’s reflections as an older woman, particularly since she is also a parent.
Thanks to Modern Mrs. Darcy and the Read Historical Fiction challenge for this great read. It will certainly show up on my end of year favorites lists, and it was a fantastic audiobook as well.
The Book Stop 
That sounds really good – a book that works as a readable story but also tells us something new about the world. Thank you for sharing!
I’d heard about this book but am much more interested after reading your review. The level of historical detail and the nuanced way it handles tough topics sounds really great.