. . . an important contribution both to studies of women's health and to critiques of development. . . . [Allen's] work among the Sukuma of Shinyanga provides a rich and vivid picture of the circumstances women face from pregnancy through childbirth. . . . Weaving together first-hand observationso with personal stories, and systematically examining the risks associated with childbirth, Allen constructs a very powerful and often-harrowing account of the experiences of childbearing women. . . . Allen's work does much to challenge the assumptions embedded in international development interventions aimed at 'Third World' women. --Journal of the Royal Anthropological Institute This rich and engaging ethnography of women's fertility-related experiences in rural Tanzania highlights the processes by which a set of seemingly well-intentioned, international maternal health policy recommendations break down when implemented at the local level. Based on twenty-two months of fieldwork in the Shinyanga Region of west-central Tanzania, Managing Motherhood, Managing Risk explores how maternal health risks have been defined and addressed at the global, national, and local levels. Beginning with an examination of how maternal health risk was defined and addressed during the early years of British colonial rule in Tanganyika, and moving to a discussion of an internationally conceived maternal health initiative, Denise Roth Allen explores the similarities in the language used and solutions proposed by health development experts over time. The case studies presented throughout the second half of the book reveal that the concept of risk in the context of pregnancy and childbirth is extremelycomplex, involving the interplay of spiritual, physical, and economic aspects of everyday life. Managing Motherhood, Managing Risk employs an innovative approach to the analysis of maternal health risk, one that situates rural Tanzanian women's fertility-related experiences within a broader historical and sociocultural context. It will be of interest to a variety of audiences, including individuals pursuing advanced study in medical and socio-cultural anthropology, development studies, public and international health, African studies, women and gender studies, and demography. Denise Roth Allen is Epidemic Intelligence Service Officer, Pregnancy and Infant Health Branch of the Division of Reproductive Health, the Centers for Disease Control and Prevention.