Labor: One Woman's Work

by Mary Fariba Afsari

A powerful memoir of medicine, identity, and family secrets from an esteemed OB/GYN as she unravels her grandmother’s mysterious death while reimagining women’s health care from a mobile clinic—for readers of The Beauty in Breaking and The In-Between.

In One Woman’s Work, Dr. Mary Afsari takes us on a deeply personal and transformative journey through her life as an OB/GYN. Set against the vivid backdrops of Portland, Oregon, and Shiraz, Iran, this powerful memoir intertwines the complexities of her professional life with the hidden truths of her family’s past, exploring the intersection of medicine, identity, and the enduring search for agency.

The story begins in the bustling corridors of an Oregon hospital, where Mary dedicates herself wholeheartedly to her patients—often at great personal cost. At the same time, Mary uncovers a long-buried family the tragic story of her grandmother Mehry’s death in 1950s Iran. This revelation propels her on a quest to untangle the threads of her family’s history while confronting the forces that have shaped her identity and her professional mission.

As Mary struggles with the oppressive realities of the medical-industrial complex and the growing attacks on women’s reproductive rights, she chooses a path of bold defiance. Inspired by her grandmother’s legacy and her own commitment to compassionate care, she decides to take her work out of the hospital and on the she converts an RV into a mobile women’s health clinic. This innovative act allows her to deliver personalized, critical reproductive health care services across the Pacific Northwest, creating community and enduring friendships along the way.

“When women don’t have a choice, bad things happen,” Mary writes. Labor is an intimate, immersive personal story, a rallying cry in a post-Roe world, and an inspiring example of what women can do when they do have a choice. Rich with the voices of her patients and the vibrant cultural threads of her Iranian heritage, Mary’s story challenges us to rethink the boundaries of health care and reclaim the autonomy of women’s bodies and lives. With warmth, insight, and humor, Labor ultimately offers a vision of transformation, resilience, and the power of reclaiming one’s path and saving other people’s lives in the process.

Genres: Memoir, Nonfiction, Medical, Audiobook, Biography Memoir, Biography, Medicine

224 pages, Hardcover

First published April 7, 2026

Reviews

[Amy Voelker · Rating 4 out of 5]

Excellent take on being a woman in medicine who genuinely cares for women at a time when all our rights are being taken away with regard to reproductive healthcare. Though there is so much doubt as to if we ever truly had them in the first place- which the author points out by comparing present day ON/GYN care to that of her grandmother in Iran. This story needs to be told and read and shared. If it doesn’t make you sad and angry read it again!

[Samantha Sass · Rating 5 out of 5]

So so so good, to all my OB girlies, this is a must read ♥️ we love a local OB legend

[alexa love · Rating 5 out of 5]

Rounded up to 5 stars because I will stay thinking about this. A quick easy read (listen) that will make you feel inspired, sad, and also furious with the state of the world. Women’s health care is SO nuanced and important and imperative. Abortion IS health care. Birth control IS health care. Really enjoyed this

[Anne Yeager · Rating 4 out of 5]

I’m a sucker for anything medical, and this writer is a hero in what she does. I loved the book, but a big surprise for me – because I was reading an on Kindle – was that it was suddenly over. I feel like she stopped too soon, or had a lot of other things to do, which obviously she did, but she left me wanting more.

[Madison ✨ (mad.lyreading) · Rating 3 out of 5]

Labor is a memoir written by a doctor born to Iranian immigrants. She is an OB/GYN, so she has a significant amount of knowledge when it comes to abortions, miscarriages, and stillbirths, and Dr. Afsari realizes that the story of her grandmother's death was a lie hiding an attempt to lose a pregnancy. That being said, this story is not fully woven throughout the memoir, but appears in pieces throughout other stories/essays related to a person's choice to have a child. This memoir is incredibly easy to read, and is extremely relevant in our current political climate. I wish there was a bit more weaving of the narrative related to her grandmother throughout, but it was enjoyable nevertheless.

Thank you to Avid Reader Press and NetGalley for an ARC in exchange for an honest review.

[CatReader · Rating 4 out of 5]

Mary Fariba Afsari is an American OBGYN whose current medical practice in Oregon includes a mobile outpatient women's health clinic set up in an RV, in addition to a hospital-based practice for labor, delivery, and surgery. Dr. Afsari's memoir Labor is eloquently-written reflection on her medical practice, certain cases and patient stories that have stuck with her (most not of the warm and cuddly variety, and most without happy outcomes), and her own experiences as a first generation Iranian-American (Afsari's parents, including her doctor father, fled Iran when she was a young child in the wake of the Iranian Revolution in the late 1970s). Many vignettes in the book recount Dr. Afsari learning the true story of how her Iranian maternal grandmother, Mehry (the woman she was named after), died in the 1950s due to complications of a failed self-administered abortion of her fifth pregnancy (with several vignettes written as narrative fiction from Mehry's perspective). Dr. Afsari also writes about her bumpy path into medicine, her midlife divorce and changes in her practice as a result of the overturning of Roe v. Wade in 2022, with some circumspect observations on the life of American women today vs. Iranian women today.

Further reading: physician memoirs with similar vibes
My Own Country: A Doctor's Story by Abraham Verghese
Love Thy Neighbor: A Muslim Doctor's Struggle for Home in Rural America by Ayaz Virji
Lifelines: A Doctor's Journey in the Fight for Public Health by Leana Wen
What the Eyes Don't See: A Story of Crisis, Resistance, and Hope in an American City by Mona Hanna-Attisha

My statistics:
Book 115 for 2026
Book 2421 cumulatively

[Deborah Rogers · Rating 4 out of 5]

While this book looks, on the surface, to be the story of one doctor's experience providing care for women. As an OB/GYN, Dr Mary Afsari, worked in a hospital and in private practice. She explains everything that entails through describing cases both routine and extreme. But her story is so much more. Her family emigrated to America from Iran during the revolution that turned the country from a progressive democracy to a repressive religious regime. Rights and privileges, including those related to health and medical care, that women once had were gone. Mary was raised in the US from the age of 3, though she still had family ties in Iran. A large part of her story, and why she became such a vocal advocate for women's reproductive rights, is the retelling of her own grandmother's death due to an illegal abortion. After 5 children in 6 years, her grandmother could not see having yet another child when they could hardly support the family they had. She drank a potion designed to end the pregnancy very early on, but it did not work. As a result she developed a fatal infection and died.
Mary is frustrated by laws and taboos in the US that do not recognize a woman's right to safe, effective health care. She sees the restrictions placed on what doctors are able to provide for their patients as repressive and dangerous. The whole system of insurance and medical care as big business is equally frustrating, and the rules of working within a hospital system are often not designed with the patient's well being in mind. She comes up with the idea of outfitting an RV to be a mobile OB/GYN clinic, taking health care to the girls and women who need it most.
I picked up this book after hearing an interview with Dr. Afsari on NPR. Her story is fascinating and heart-felt. She has a professional's insight into what is wrong with our health care system, and at the same time the heart to work to make it better.

[Cari · Rating 5 out of 5]

I didn't get to it by release date, but I have to shout out this gorgeous memoir. I am surprised I didn't know about it before I did my library's holds list - I needed to order a copy to fulfill holds, and I quickly downloaded the ARC, so I thank Edelweiss for the last-minute read. Afsari relates her experience as an OB/GYN through her life, from internship and residency through hospital and private practice and then a small mobile clinic she runs herself. She describes her experience juxtaposed with her memories of her two grandmothers, especially her maternal grandmother, whom she's named for. Every story is moving and powerful, and the entire book shows just how important women's health is to both our society and to individuals. Afsari is a gem.

[Laura · Rating 3 out of 5]

I feel like I may end up in the minority here, but this book was a bit disappointing. I think it all could have been expanded into a longer book. There was so much brevity to this book that I feel like I only had a small glimpse of the stories included. It didn’t have any sense of intimacy that usually comes with a memoir, almost as if the author doesn’t trust the audience with a deeper dive. I wanted to know more about everything she wrote about, but it just wasn’t there.

[Chad · Rating 4 out of 5]

What an amazing, inspiring wellspring of a book! Afsari chronicles the hard work on the front lines of women’s healthcare in America. She has a certain prospective as a woman born of immigrants, and the story of her family is told in tandem with the stories of her patients. Much of it is harrowing, maddening and sorrowful. But the surprise is what a good writer she is. Afsari puts her money where her mouth traveling around in an RV bringing care to the marginalized or underserved or those who have lost their trust in the system. This is a read that will stick with me for awhile.
4.5 stars

[Elizabeth · Rating 5 out of 5]

Listened to this memoir on audio, read by the author. I love medical stories and this kept me thinking about womens’ healthcare in the US. She tied her story to her grandmother’s which added a valuable layer.

[Madison · Rating 4 out of 5]

I’ll be thinking about this one for a while - It portrays an innovative way to provide healthcare and is full of emotional stories.


“An invisible charge runs between them, and the toddler injects her mother with enough voltage to get her through the next few hours. This is motherhood, Mehry thinks. Down one moment, up the next.”

[Susan Gerstner · Rating 5 out of 5]

"When women don't have a choice, bad things happen. When women don't have a choice, we know how their stories end." -Dr. Mary Fariba Asfari

[Carie · Rating 3 out of 5]

The organization of this book made it a read that did not easily flow for me. The stories were interesting, but the back and forth of the timelines was a miss for me.

[Ally · Rating 5 out of 5]

Such an incredible woman and important narrative

[Maureen Meyer · Rating 4 out of 5]

Good reminder of the difficult work many choose to do every day and in every way.

[Liliette 💘 · Rating 5 out of 5]

This book found me at the perfect time and I am so thankful for it. Best nonfiction I have read (or listened to) in ages.

[Rae · Rating 3 out of 5]

Short and not as emotionally involved as I usually prefer, but very thought provoking

[Alan · Rating 5 out of 5]

Amazing and inspiring book!

Labor: One Woman’s Work is a truly great book, a story of how a very bright woman became an Ob/gyn then after 10 years moved her practice to an RV to become more accessible to her patients. I learned A LOT about women’s medical issues, birth, abortion, and the life of a very caring doctor. The writing was very clear, fast moving, and descriptive. As I was reading I felt the author’s emotions deeply and also my own emotional reactions to difficult medical problems and interventions. The author shared with honesty and insight how her family history and family life affected her medical practice. Throughout the book I felt inspired by the author’s tale of her life.

[Eryn Dutta · Rating 5 out of 5]

Excellent medical memoir

I really enjoyed this. It interweaves being an Iranian immigrant and OB/Gyn. It was published this year so does address challenges in women’s health care.

[Marcia Miller · Rating 4 out of 5]

I heard about this book while listening to NPR, and knew I needed to read it.
I inhaled it in one day.

Dr. Mary Fariba Afsari weaves details from her own fascinating family history with her professional life as an OB-GYN doctor who decides to leave a standard hospital setting to create a drive-in van tricked out to go to patients who live far from hospitals in the part of Oregon where she lives with her family.

It's a fascinating read that filled my heart with gratitude for her openness and sense of community, espcially in these times of denial and/or cutback regarding the necessities of women's access to maternal health in our nation.

[Brianna Cohen · Rating 2 out of 5]

Very interesting plot and life story- but the manner it was written felt fairly disjointed to me. 2.5 stars.

[Off Service Book Recs · Rating 5 out of 5]

"It's not an act of love if you make her / You make me do too much labor"

From the modern, beeping, activity-filled halls of a Portland, Oregon medical center to the sun-drenched home of her doomed grandmother in 1950s Iran, Mary - an OB/GYN straddling two worlds takes readers on a journey between past and present, identity and belonging, family and personal missions, as she unravels the ghosts of her family's past while confronting the realities of reproductive healthcare access in America.

"When women don't have a choice, bad things happen"

In the face of the battle being waged on women's healthcare and reproductive access, Mary - inspired by her grandmother's legacy - opens a mobile women's health clinic, retrofitting an RV to bring healthcare to those who need it most but who may not be able to access it for any number of reasons. Bold and defiant in the face of a post-Roe world, Mary serves as an example of what women can do when they DO have a choice. Rich in history, memory, resilience, loss, love, friendships, and the yearning for what could have been and what could be, "One Woman's Work" is a rallying cry for healthcare workers and private citizens alike to rethink the boundaries of health care and reclaim the autonomy of women’s bodies and lives.

I absolutely devoured this book - as someone who thought long and hard about OB/GYN as a career path and for whom reproductive justice and women's health remain incredibly vital pillars of medicine as a career, this was an incredible memoir. I remember where I was and what I was doing when Roe fell, and for the past several years each new story in the news of a right lost, a life snuffed due to inadequate healthcare access, and a freedom stripped away has been incredibly disheartening. Mary's story - her personal journey through medicine, her motivations, the family secrets which lit a fire in her to offer something new and radical in the sometimes rigidly inflexible realm of healthcare, and her dedication in the face of insurmountable personal and financial struggles was incredibly inspiring.

There are good people out there trying to do what is right even when it isn't easy, and in the face of such injustice in the world - especially for the most vulnerable among us - knowing people like Mary are out in the world, bringing healthcare to those who need it one gas station visit and generator refill at a time is inspiring, heartwarming, and definitely has me looking at what local organizations I can devote some of my time and resources towards. Congratulations to Mary on a fantastic book and accomplishment in the founding of her mobile clinic, and I look forward to following along with her work in Oregon!

[Briar · Rating 3 out of 5]

TL;DR: A solid introduction into why female reproduction health care and rights are important.

This memoir is written in a fairly non-offensive or controversial way. Dr. Afsari lays out different cases that she’s worked on and how that relates to the importance of women’s bodily autonomy. While the book can’t be called apolitical, because of how the United States views supporting reproductive health as being a mostly left leaning political position, it is advocating in a gentle sort of way. What do I mean by that? The book uses the different women’s cases to install a sense of pathos before Dr. Afsari makes her argument for that section. The book is filled with anecdotes and stories rather than using data/statistical analysis and data interpretation. For the most part, I do think that the book does a good job of focusing on and supporting its central argument.

Maybe a third of the book is focused on Dr. Afsari’s grandmother whose death during pregnancy influenced her choice to become an OB/GYN. These sections are often written with the grandmother narrating her thoughts, conversations, and relationships. While I do find these some of the most compelling and well-written parts of the book it was odd for me, personally, to read what’s functionally conjecture as if it were fact. I think it’s absolutely alright for Dr. Afsari to heal by writing about her grandmother, but I don’t know if it really fits in seamlessly with a memoir about Dr. Afsari’s life.

Throughout this I’ve said that it’s about womens’ reproductive health. While Dr. Afsari does mention that she sees queer patients she frames that as only for HRT. This isn’t a book that ‘s going to focus on the overlap between queer identities and reproductive health. While I think that was done to keep the book from reading as too political, it was sad to see the emphasis on reproductive rights being about women and mothers . The book really only hones in on pregnant women even though there is more to the OB/GYN field.

[Carlee Ranalli · Rating 4 out of 5]

This is one of those books that stays with you, not because it’s loud or dramatic, but because it is honest and grounded in lived experience.

What struck me most was the way Dr. Afsari plays with the idea of “labor” itself, moving fluidly between the physical act of childbirth and the broader, ongoing work women carry every day. That dual meaning unfolds naturally throughout the book, creating a powerful throughline that connects the deeply personal with the universally recognizable.

She captures the complexity of women in society in ways that feel both intimate and widely understood. The book moves beyond traditional narratives to explore the emotional, physical, and often invisible dimensions of what it means to carry responsibility, whether in professional spaces, physically, in caregiving roles, or the spaces in between. There’s a quiet clarity in her writing that makes you pause and reflect on how much is taken for granted.

It made me reflect on what we mean by “labor,” how we value it, and how differently it shows up for women balancing multiple roles and expectations. At the same time, there’s a balance between insight and storytelling that keeps it engaging and accessible.

What I appreciated most is that the book doesn’t offer easy answers. Instead, it creates space for reflection, which, in many ways, feels more powerful. It invites the reader to consider their own experiences and assumptions.

Overall, Labor: One Woman’s Work is both meaningful and enjoyable, a combination that isn’t always easy to achieve. It’s a book I would recommend to anyone interested in understanding the nuanced realities of women in society, or simply looking for a thoughtful and well-written read.

[Aria · Rating 4 out of 5]

I love a medical memoir. Among my favorites:

The Pact: Three Young Men Make a Promise and Fulfill a Dream x “The Three Doctors”
When Breath Becomes Air x Paul Kalinithi, MD
Black Man in a White Coat x Damon Tweedy, MD
Legacy x Uche Blackstock, MD

I can now add Labor: One Woman’s Work by Dr. Mary Fariba Afsari to the list.

Dr. Afsari is a Portland-based OB-GYN. In Labor, she (non-linearly) traces her path from daughter of exacting Iranian immigrants, to public health work, to medical school, to working motherhood juggling clinic and childcare, and finally to owner and operator of her own mobile OB-GYN clinic. Throughout, there are the expected retellings of patient stories, but also whispers of her own family’s story. Mehry, her maternal grandmother and namesake, died of pregnancy complications. For Dr. Afsari, women’s care is personal.

This memoir spans the years 2018 - 2025, with presidential elections and the reversal of Roe v. Wade providing an important sociopolitical backdrop to Dr. Afsari’s stories.

If anything, I wanted her to go deeper on what she’s up to now with the mobile clinic. As someone whose career is focused on getting people care at the right place and at the right time — even and especially outside of the traditional four walls of a clinic — I found myself fascinated by that part of her story.

Less a criticism than a compliment. This is a short book (200 pages) and I simply wanted more. More about the mobile clinic and building something from scratch to reimagine women's healthcare beyond the traditional doctor's office.

4 ⭐️

[Jeannette · Rating 4 out of 5]

This is such an important and interesting book. Afasari is an OB-GYN living in Portland, OR, and the child of Iranian immigrants. One Iranian grandmother was institutionalized with postpartum psychosis after the birth of her 4th child and never seen again. Her other grandmother died after drinking an abortive tea that didn't exactly work (she was pregnant with her 5th child in 6 years). The fetus died, causing a gangrenous condition that killed the mother too.

Afsari interweaves these family stories - and stories about her medical training in Bolivia where women bought IUDs off the black market because contraception was banned - with true stories about her patients, including a pregnant teen who was most likely raped by a relative she lived with, a case of twin-to-twin transfusion syndrome and a young woman who develops a life-threatening infection that costs her her uterus and almost takes her life.

Afsari started a clinic on wheels, providing OB-GYN care from an RV for all people, but especially for minorities, trans people and others who don't feel safe coming to a medical office. She's quite a force. It's a shame that, as she states, our current leadership and state involvement in women's health have so greatly impacted women's access to life-saving healthcare - and yes, abortion is healthcare.

[Emily Pukuma · Rating 5 out of 5]

In this powerful memoir, an ob-gyn shaped by her family’s Iranian immigrant roots reflects on her years practicing medicine in Oregon—years marked by tireless commitment to patients and a growing heartbreak at the system’s persistent failures in women’s safety and care. As she confronts the daily realities of a healthcare structure that too often sidelines women’s needs, she undergoes a profound personal and professional transformation.

Threaded through her story is the legacy of her grandmother, Mehry, whose tragic death in childbirth becomes a generational echo of what can happen when reproductive care is shrouded in silence and stigma. Her grandmother’s experience—steeped in cultural constraint, unspoken expectations, and the absence of accessible support—shapes the author’s understanding of the stakes of her work and the urgency of advocating for women who have been historically unheard.

Haunted by the stories she inherits and the ones she encounters in clinics and delivery rooms, she begins searching for new ways to care more deeply and more directly. What follows is a journey of reinvention—from burnout to bold self-expression, from quiet reflection to the creation of a mobile ob-gyn clinic that allows her to meet women where they are, especially those most marginalized by traditional healthcare.

As Roe v. Wade falls and reproductive rights constrict nationwide, her mission sharpens. With access shrinking and fear rising, she steps forward, determined to provide care in a landscape increasingly defined by abandonment.

Bold, intimate, and fiercely compassionate, this memoir charts one woman’s search for purpose within a politicized healthcare system. It is a testament to resilience, advocacy, and the radical impact of showing up with humanity.

A vital read for anyone navigating the uncertainties of a post-Roe world, it champions courageous action, empathy above all, and the power of choosing a path devoted to women’s well-being.

[Catherine Chapman · Rating 5 out of 5]

This was such a great way to start my reads of 2026. There’s women like Dr. Mary Fariba Afsari out there who are looking out for the future of my daughter’s rights and I’m a better person for reading her story. As I read this book I was angry, scared, sad, but by the end I felt hope. Hope that there’s more doctors out there willing to fight and do something crazy and new like turning a vehicle into a mobile practice for reproductive healthcare. While moving through this book the reader gets to see numerous different clinical situations that had permanent impacts on how the author views reproductive healthcare and the importance of what she does.
I also learned a lot about Iran and the struggle they have been experiencing while reading this story. My favorite aspect of the story took place in Iran as we get glimpses into what the author’s grandmother had been through while seeking an end to an unwanted pregnancy and how it may have ultimately led to her death. I loved the way the flashbacks offered a needed break from current events. It was still hard to read at times, but it gave a break by looking into the past. “Zan, Zendegi, Azadi” Woman, Life, Freedom.

[Candace · Rating 4 out of 5]

Thank you to NetGalley and the publisher for this early release of a truly beautiful memoir.

This review is in my words and opinions are my own.

What a powerful memoir to start my 2026. The way Dr. Mary Fariba Afsari writes is captivating, raw and powerful. I am thankful for reading her story and knowing there are doctors out there like her in the corner for women and women's healthcare. As a mother of two who had emergent deliveries both times; as a woman who deals with varying levels of hormone dysfunction on the regular, I am grateful to the doctors I have encountered who listened the same way that Dr. Afsari does to her patients.

I found myself in tears many times throughout this because her passion and attention to detail for her patients was heartwarming. I was gripped by what happened with her own grandmother in the face of what happens when women's health is not taken seriously and taken care of.

I would highly recommend this book to anyone, really. Men and women alike. Be prepared to feel deeply for the author, the women who she cares for and the women in your life. Wonderful read <3