I received a digital galley of "A Good Time to be Born," from Net Galley in exchange for a fair review.
In general, this book gives an insightful overview of the medical advances over the past few centuries that have been critical in improving infant and child mortality. Klass does a nice job reviewing primary source material from public health workers, nurses, physicians and researchers that intelligently includes the contributions of African-Americans and women that have taken an event--childhood death--that used to be so common among both impoverished and wealthy families to where as now a childhood death is looked upon as unusual.
When I first started reading the book, I became worried about the repetitiveness of how many similarities of the following statement occurred, "In previous centuries, no matter how rich and powerful parents were, no matter how many important doctors they could summon, they had a very limited ability to protect the children they loved," in the introduction and first chapter. The first chapter is essentially a review of how childhood death was portrayed in literature that emphasized the above quote. Portions of the first chapter could have been integrated into the other chapters to humanistically represent what cultural productions like plays, literature and movies portrayed about children's health. Fortunately, Klass eliminated my frustrations in the first sentence of Chapter 2 by starting it with the following sentence quoted from the anti-slavery newspaper ,The Liberator: "American mothers! Can you doubt that the slave feels as tenderly for her offspring as you do for yours?...Will you not raise your voices, and plead for her emancipation?" She then gives a forceful, inspiring narrative (including an 1860 document listing the prices of enslaved people), how African-American children suffered under the savagery of slavery and how African-American writers poignantly captured the grief of seeing their infants die, experiencing the same grief and loss as Caucasians and then continuing throughout the book highlights the important contributions that African-American pubic health workers, nurses and physicians contributed to improving childhood mortality. This is history that is inclusive and inspiring.
The book goes on to highlight what you would expect a medically-focused history of childhood mortality to address--breastfeeding, infectious diseases, vaccine, the development of Neonatal Intensive Care Units, etc. All of which appear to be grounded by historical research and her clinical experience as a pediatrician when some of these developments occurred. She does a nice job explaining medically-related concepts in an easy to understand format but does not lose a more general reader who might be less interested in a scientific explanation of how these advances led to improved mortality.
That said, a medical focus on improved mortality will necessarily not provide a comprehensive overview of the entire story of improved childhood mortality. Although Klass mentions other factors as early as the introduction-- poverty, education, environmental, personal behaviors--that contribute just as much, if not more, to improved mortality, these are not explained to any substantial degree, nor is HIV/AIDS in "A Good Time to be Born." Legislative and legal contributions, including regulatory improvements in environment, housing and labor, are also not given equal treatment compared to medical advances. This is not necessarily a fatal flaw, just that the book reflects the author's background in the medical sciences. Klass also mentions and laments how there is still a difference between African-American infant mortality versus Caucasian infant mortality. Even though rates have dropped precipitously compared to prior decades and centuries, we can't declare victory until this rate narrows and here is where a broader view of overall health rather than just medical care can help better inform these disparities of care and what needs to be done to advances these social determinants of health. Lastly, there is no discussion on how medical harm through the delivery of care sometimes contributes to less than optimal pediatric health outcomes.
I don't want this review to focus on the potential omissions of Klass's book on why childhood mortality has improved over the past centuries, particularly because in her skillful telling she highlights the humanity in children and their families that you end up inspired by reading her narrative and want all of us to continue to ensure that all children grow up loved, cared for and supported by their parents and their communities. Although I didn't give this 5 stars, it still should be read for its literary and medical history merits.