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 fans 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, Medicine, Health

Audible Audio

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!

[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

[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

[Jennifer Nelson · Rating 5 out of 5]

Listened to the audio book and completely enjoyed Dr Afsari’s memoir. Very interesting to be inside the world of an Ob/gyn who is navigating how to effectively provide women’s health in today’s world. Competent and caring doctors are a true gift to all of us, and Mary clearly is one of the best. The weaving of her grandmother’s story as well as her own first generation immigrant experience gave the book depth as well

[Sarah · Rating 5 out of 5]

You know what? 5 stars. Labor is part memoir, part manifesto—a doctor reckoning with the state of women’s healthcare post Dobbs is going to have a strong point of view—and with a personal family secret on top of it? You’d think a book like that would be long, but Labor is incredibly short, and a page turner. I told myself I was going to read “one more chapter,” but a) I couldn’t stop and b) before I knew it I had hit the epilogue. Fair warning, there are some descriptions of medical procedures, so avoid if especially squeamish.

[Stephanie Flood · Rating 5 out of 5]

This is a beautifully written memoir. Dr. Mary Fariba Afsari's is a first-generation Iranian woman physician, OB/GYN, mother, and believer in the importance of choice in women’s healthcare.

She shares her life as a physician with honesty and compassion, including the painful story of her grandmother’s tragic death and how that experience shaped her commitment to providing equal care to every woman. Whether working in a hospital or in her medical clinic, she remains focused on making quality care accessible to women who might otherwise have limited choices.

As someone who has spent decades working in Labor and Delivery, I found her perspective especially meaningful. Her story makes it clear that the way we care for patients is often shaped by the experiences that have touched our own lives.

Well written and deeply personal. I highly recommend this book.

[Helen · Rating 4 out of 5]

Dr. Mary Fariba Afsari is an Iranian born women who immigrated with her family to the United States when she was a young child. She is a board certified Obstetrician and Gynecologist who has dedicated her life to women’s health. Her family history from Iran, and her experiences as a physician here in the United States, are awe inspiring. This small book was a most enlightening and enjoyable read.

[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.

[Kristine · Rating 4.75 out of 5]

This memoir moved me powerfully. As a woman, a doctor, and an advocate of women’s reproductive rights, Dr. Afsari shares her raw and moving story of trying to navigate being a woman, an immigrant, and an ob-gyn in an age where our freedoms are increasingly at risk.

[Sarah Laney · Rating 4 out of 5]

A nice memoir, helped me process some of the emotional things you see working in obstetrics.

[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.

[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.

[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

[Kari Yergin · Rating 4.5 out of 5]

So, so powerful and very approachable and short. Life is complicated and being a woman adds a whole layer of complications not always addressed as well as it should be. Fascinating stories of the patients this doctor works with as well as her own grandmothers.

EXCERPTS:
When women don’t have a choice, bad things happen. When women don’t have a choice, we know how their stories end.

How do we ask women to make choices about their pregnancies when the pregnancy itself is clearly not a choice?

She’s a languishing 26 year-old. A few years earlier, the word used to describe her would’ve been zeba in the Persian language: glowing, beautiful, radiant. As the babies come, a layer of youthful sheen shimmers off. She does not lose her beauty, but, as with many women burdened by the weight of pregnancies, births, infant care, and household, the beauty transfers, sparkles of light bounce from her into the glowing brown eyes of her children, her smooth skin rubs off when the two year-old, the four-year-old, the five-year-old, and the baby are bathed and lotioned. She holds their bellies to her face and breathes. As her cheek rests on their bodies, invisible, slivers of herself remain behind, layers come off. She senses that she is becoming slowly exposed. And, she is pregnant again.

When identical twins are forced to share the life blood of one placenta, a creeping imbalance can arise within the uterus. The maze of vessels used to feed each one its fair share of fluid, blood, and nutrients can lose its way and shunt entirely towards one baby and away from the other. It is called twin to twin transfusion syndrome TTTS. The life pouring into one deprives the other one. Common sense makes us think that the little one, the stuck one, the dry one would fare worse, but this is the one who more often survives. The stress of deprivation increases survival. The hormone cortisol is created in higher amounts and it stimulates the fight for life in this frail but feisty baby. The abundant one, the inadvertent receiver? This is the one more likely to die.

I often found myself contemplating medical school. It was what had been expected of me and so I had been resistant to it.

The children tickled and danced, jumped and played They created an ambience of normalcy around her. . As long as she could hear their voices and touch their skin, she was still alive, although the death within left her feeling like an apparition. What happens to the vessel carrying a ghost?

[Debbie Gale · Rating 4 out of 5]

CW: medical trauma, vehicular trauma, death, graphic childbirth, traumatic post-birth, child SA/r*pe, misogyny, sepsis, tramatic post-abortion, etc.

I am conflicted on how to rate this book, as it is a memoir and this author's story.

Mary Fariba Afsari is an OBGYN and this memoir is about her experience as a physician who opened up a mobile health clinic for rural areas in the West. Afsari also weaves in her experience as the daughter of parents who immigrated to the United States from Iran. Her father is also a physican.

My favorite parts of this memoir was the speculative nonfiction sections where the author wrote about what happened with her grandmother (who lost her life due to pregnancy complications) who is the author's namesake.

I appreciated the author sharing her experiences as an OBGYN, but I was hoping for more from this book. I kept wanting more of her expertise. She talked about burnout and switching to the mobile telehealth but didn't go into the details of WHY medicine is so broken. She talked about sewing up a patient whose vagina "exploded" but didn't explan what that meant or what exaclty she was sewing up. She talked about a patient with gas gangrene post an abortion but didn't go into any details about why gas gangrene happens or how that is different from "regular" sepsis. I was hoping for memoir-plus (her adding more of her medical expertise) but this book is really straight memoir. Which is cool-- just having expectations correct might be good going into this one.

There were also just a lot of loose threads at the end of this book. I know it is an ongoing story, but I would've loved if Amelia's story had been revisited even if she just reminded us she didn't have any update.

It is a short book and worth a read but I was just hoping for 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.

[Erin Drake · Rating 3 out of 5]

This Iranian American physician’s memoir is a commentary on reproductive healthcare in the US. She draws from her own experiences in training and in setting up a mobile clinic in an RV (impressive) and also the imagined experience of her grandmother in Iran who died in pregnancy. The experience of her grandmother serves as almost a warning for post Roe America. I liked it, I just feel exhausted of our country and maybe too burned out by women being failed over and over again to give an unbiased impression.

[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

[Ellen · Rating 4 out of 5]

This is a powerful book of one woman's courage and commitment to address a broken system of women's healthcare. It's a must-read for 3 groups of people -- categorical opponents of abortion, men in general, and everyone else. We all need to up our game and expand our knowledge to correct the injustice.

[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.”

[Laci Lynn]

Checked this out from the library after I saw Barbara Kingsolver’s praise of the book and its author. I highly recommend for my friends in the medical field or anyone interested in women’s healthcare.

[Meri Schroeder · Rating 4 out of 5]

Walk in the shoes of an OBGYN. Great insight into women's health care in the words of a professional who lives and breaths it daily. People who are totally against abortion might gain some insight from this read.

[Princess Peach · Rating 5 out of 5]

Beautifully written. What a thoughtful book. I wish everyone would read it to better understand the nuance of healthcare for women. My heart breaks that Afsari's marriage ended, which was mentioned in the book but not the subject of her story. I am very impressed at all she has accomplished and on top of that to write such an excellent memoir... Wow.

[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.