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, Audiobook, Medical, Biography Memoir, Biography, Health

224 pages, Hardcover

First published April 7, 2026

Reviews

[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

[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.

[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.

[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.

[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.

[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

[Rae · Rating 3 out of 5]

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

[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.

[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!

[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

[Blue Ant · Rating 5 out of 5]

What stayed with me after reading Labor was the way Mary Fariba Afsari connects the intimate realities of reproductive care with the inherited silence surrounding her grandmother’s death. The memoir continually moves between hospital corridors, family history, and the roads of the Pacific Northwest, creating a structure where personal investigation and medical practice reflect each other.

I especially appreciated the tension between institutional medicine and individualized care that runs through the book. The decision to transform an RV into a mobile clinic feels less like a symbolic gesture and more like the natural culmination of the frustrations, ethical conflicts, and emotional exhaustion the memoir carefully builds throughout. The inclusion of patient voices also gives the narrative a collective dimension, reminding readers that debates around reproductive rights are lived through everyday bodies and circumstances.

This book will reward readers interested in memoirs where professional identity and family history are deeply intertwined. It left me thinking about how medicine can become both a means of survival and a way of reclaiming agency across generations.

[Ellen Garbsch · Rating 5 out of 5]

This was a very well-written and thought-provoking book about life as an OB-GYN and Iranian immigrant! I really enjoyed how this doctor told her story through sharing both family narratives from the past as well as connecting the relevance of her work to American society today. Several of my favorite quotes ...

1. "The people of Iran are an educated, literate, mobilized population who remember what it felt like to have wind in their hair and fingers interlocked walking down the street. They are us."

2. "My parents left their country in order to provide me with a lite where my autonomy was protected.
Valued. Supported. Even encouraged," I continued. "And now, another version of me, the one that would still be there if my parents hadn't left, is being shot and killed in the streets for daring to show her hair." I listened to my own voice—I had never explained this before. "This fight for bodily autonomy, it starts with one person, one torment. And if we do not stand for that, it spreads to all of us."

[Alicia · Rating 5 out of 5]

Bowled over by this amazing biography by Dr. Afsari who details her work as an OBGYN including her pathway but also her work/life balance, her moral compass when it came to treating women, and also her discovery about her own family's past when it came to maternal care.

This audiobook was transportive and informative in a way that I adore from biographies of fascinating topics that need more attention. And it's often hard to balance the storytelling and the biography without going too far in either direction. This mix was PERFECT. As an Iranian woman and a caretaker for women with her own children, she triangulated throughout her career what mattered to her most and set out to accomplish it when it meant creating a mobile care unit. Her tenacity and dedication shines as well as the individual case studies that demonstrate different aspects of patient care like sexual abuse to disrupted pregnancies.

[Mirela · Rating 3 out of 5]

While I appreciated the compassionate tone of this memoir and found its insights into women’s healthcare compelling, the book didn’t fully come together for me. Afsari clearly cares deeply about her patients, and some of the medical stories were moving and eye-opening, but the narrative often felt self-congratulatory in a way that made the stakes feel less authentic. The grandmother storyline, despite the author’s attempts to draw a meaningful parallel across generations, felt disconnected from the rest of the memoir and never quite landed emotionally. I also struggled with the central arc of a burned-out physician responding by taking on even more work through a mobile clinic—it never really made emotional or practical sense to me, and the book didn’t grapple with the contradictions at the center of that choice. Overall, there’s a lot to admire here, but the book felt less cohesive than I’d hoped.

[Mothie · Rating 4 out of 5]

I think this is a very valuable position. I like how the narrative moves between the author's office/RV, her personal life, the world of politics and the story of her grandma, different storylines interwoven into one complex braid. Mary Fariba Afsari is a great storyteller and seems like an amazing doctor as well — fighting to provide healthcare despite political and personal difficulties. My only criticism is that I think she should have gone more in-depth when it comes to some things, especially the purely medical elements of the story. The book is rather short and while I think to a degree it makes it easier to read and hence may help spread its core messages, I was left wanting to read more.

[Veronica · Rating 4 out of 5]

Dr. Afsari is the daughter of two Iranian immigrants who fled their country in 1978 due to the extremist Islamic government takeover. 

This memoir is emotional, but mostly, is a warning. 

What happened in Iran could happen in the United States. It is currently happening, and can get so much worse if we stay on this path. A pro-billionaire capitalist government that brainwashes and weaponizes people as extremist religious pawns. It's Iran; it's the U.S. It's so scary and hopeless. 

As far as taking away the rights of women, the LGBTQ community, immigrants, etc. Dr. Afsari wants us to keep in mind, "We are only as free as eachother is free." 

Anyway, welcome to post Dobbs America where all us girlies can do is stick together. The people who need to read this book won't, so whatever. 

[Wendy Regan · Rating 4 out of 5]

Most physicians enter medicine with a deep sense of grit and a genuine desire to heal. While those qualities can make them exceptional caregivers, they can also place both male and female physicians at risk for burnout. The drive to serve others, coupled with relentless perseverance, often leads physicians to neglect their own needs, values, and well-being.

I commend Dr. Mary Asfari for having the courage to listen to her inner voice and reimagine a career in medicine that nourishes rather than depletes her. Her willingness to challenge conventional expectations and honor her own integrity is both radical and inspiring.

The themes of this book are refreshing, liberating, and deeply validating. Dr. Asfari reminds us that caring for ourselves and living in alignment with our values creates fulfillment not only in our careers, but in every aspect of our lives. Her story is one of courage, authenticity, and boldness, and she deserves to be celebrated for leading the way.

[Mary · Rating 4 out of 5]

Thanks to Goodreads Giveaways for this wonderful book. I felt, at times, that I could see this lady and her obvious love for her patients as well as her profession. I am recently retired from 40 years as a Physical Therapist Assistant and so totally understand how frustrating the Healthcare system has become when it feels like Healthcare providers are fighting to find the time needed to provide the care each person deserves. I love her solution of the much more private and inclusive RV Clinic. This is a good book for all readers to get a better view of just how many diverse situations there are in this so necessary specialty!!

[Emily · Rating 4 out of 5]

normally I try to not rate memoirs or autobiography’s bc who am I to judge on how people tell their stories however this will be an exceptions. a good storyteller is someone who makes you feel like you’re with them the entire way and she did that. I felt her love, her compassion, her charisma, her passion while reading this book and felt like I knew her truly even though we’ve never met. and I think that’s why I make an exception because I felt like I was with her the entire time she was going through her life and felt as though she was telling me about it face to face rather than reading it. it’s such an amazing book and I’ll be recommending it to everyone.

[Poornima · Rating 5 out of 5]

I just finished reading this book, and it was absolutely excellent. It gives an eye-opening perspective on how a gynecologist treats patients from all different backgrounds, especially when politics and religion get mixed up in women's healthcare. It is heartbreaking to see how no matter where you are in the world, as soon as an oppressive regime takes root, women are always the ones who are immediately targeted and are affected the most.

I also loved how the author brought her own Iranian-American background into her life and work in the US, and I highly recommend this powerful book, especially in this current climate.

[Adam Axler · Rating 5 out of 5]

An unbelievable story. A doctor's fight to bring essential and life-saving care to her patients. Who looked burnout in the face and said I need to do more, not less. All at great personal sacrifice. To honor women who have had healthcare stripped as a personal freedom. To honor her grandmother, who didn't have the choices we have in this country.

Dr. Afsari's memoir is an incredibly important one, a must read for anyone who cares about women's health and reproductive decisions in this country.