Bernice L. Hausman's Viral Mothers makes an important contribution to the growing body of literature investigating maternal practices as they are exercised in the presence of (real and imagined) biomedical risk. Viral Mothers presents an insightful Foucauldian analysis of the discursive construction of the maternal/infant body, examining infant care regimes as they exist within the domain of biopower. As Hausman notes in her introduction, Viral Mothers "is not about real women, but [is] a set of critical commentaries concerning conflicting ideas about motherhood, particularly the embodied practice of breastfeeding" (3). Hausman's analysis provides crucial insight into the complex forces informing maternal feeding practices, forces frequently occluded by medicalized modernity's rhetoric of "informed choice." However, Hausman's determination to write "not about real women," but about mothers and infants as rhetorical constructs, diminishes the argument's power by threatening to perpetuate the same dehumanization of the mother/infant upon which Enlightenment-based biopolitics thrives: namely, privileging the discursive figure over the living subject.

In Part 1, "Frames," Hausman lays the groundwork for her discussion by assessing the paradoxical rhetoric of breastfeeding as both medicine and toxin, arguing that the maternal body is appropriated within a regime of surveillance and medical intercession predicated on an insistence on maternal purity. She artfully deploys Charles Taylor's theory of "disembedding" to articulate the decontextualization of the maternal body. According to Taylor's framework, medicalized modernity is characterized by the privatization of the individual body, severing the body from its sociocultural context. For disability-studies scholars, particularly those working within the Foucauldian model of biomedicine, Hausman's discussion in this chapter presents an important examination of the medical model's infiltration of infant feeding practices. Here, Hausman persuasively argues that maternity has been medicalized through the institution of a modern risk society, with breastfeeding functioning in the global north as a medical practice subject to the scrutiny, regulation, and intercession of authorized experts. For Hausman, disembedding is a foundational practice that enables, rationalizes, and naturalizes maternal submission to abstract authorities grounded in the medical model, supplanting traditional, context- and community-based systems.

Hausman deploys her analyses of medicalized modernity in Part 1 to set up an important discussion of the complex machinations of biopower operating through global north/south relationships. Medicalized modernity, Hausman argues, establishes a framework of discursive and embodied practices premised upon ideologies of risk assessment and informed choice. She extends into the field of maternity Foucauldian models of "discipline," in which individuals affirm their status as subject-selves by internalizing and enacting codes of conduct that perpetuate modern social systems. "Modern" identity presumes the capacity to make rational choices as defined by and insisted upon in the power/knowledge structures of the biomedical regime. Within this framework, the consumption of medical knowledge and the deployment of this knowledge in making "rational" choices (i.e. choices authorized by the medico-scientific regimes of the global north) normalizes the submission to biomedical regulatory powers. This process situates the modern subject in opposition to the "pre-modern" subject of the global south who, for a myriad of reasons—from lack of access to vital resources, to inadequate infrastructure, to an inability to acquire and/or appropriately utilize medical information—fails to enact the mandates of the biomedical regime.

Parts 2 and 3 of Viral Mothers expand on the strong foundation built in Part 1 to investigate the often catastrophic consequences of modern medicalization for mothers and infants worldwide. Hausman opens Part 2 with a subtle analysis of the risk society, offering a compelling explanation for the normalization of formula feeding despite broad public support for breastfeeding. For Hausman, this dichotomy arises from a highly selective process in which patterns of perceived risk function to authorize, mandate, and perpetuate prescribed behaviors among a myriad of potential choices for mothers. Hausman takes her discussion of the risk society from, among others, the work of Ulrich Beck, Anthony Giddens, Mary Douglas, and Aaron Wildavsky, arguing that "cultures select specific risks among the panoply of possible risks because those selected represent, symbolically and materially, risks to the institutions on which the culture depends" (53). According to Hausman's analysis, patterns of risk selection in the global north enable an emphasis on the risks associated with breastfeeding while minimizing threats related to formula feeding. The seeming contradiction exists because, while breastfeeding corresponds with ideological constructs of maternity, formula feeding conforms to the material practices on which modernity is based in the US. For example, the Enlightenment-based premise of the autonomous, private body authorizes and enables the mother's expected participation in the workforce, a participation which current infrastructures cannot accommodate with breastfeeding.

Hausman follows her discussion of the modern risk society with rhetorical analyses of political, scientific, and media representations of two contemporary events: the appearance in the US of the West Nile Virus and its purported link with breastfeeding in the 1990s; and the 2004 US National Breastfeeding Awareness Campaign. Part 2 concludes with three important chapters on mechanisms through which cultural consensus on the risks of formula feeding is denied. Here, Hausman furthers her examination of the image of maternal purity and its relationship to the regulation of breastfeeding by analyzing the rhetorics of pregnancy advice books. She thoughtfully extends the earlier discussion of Taylor's theory of modern "disembedding" to the self-help genre, arguing convincingly that bonds of communal support and knowledge-sharing, particularly as practiced by and among women, have been replaced by abstract authority figures situated in the medical model. Further, Hausman notes, pregnancy advice books operate upon the premise of maternal purity that identifies breastfeeding simultaneously as the optimal nutritional choice and as the first site of contamination should the mother fail to adhere to largely unfeasible standards of bodily purity. The medicalization of the maternal body, its cooptation within and submission to medical authority, helps to regulate maternal behavior within a rigid construct of risk/benefit analysis, as women assert their fitness as mothers based on their ability to make "proper" choices. Hausman's analysis of the infiltration of biomedical mandates into infant care choices makes an important contribution to the growing recognition within disability studies and women's studies of the influence of pragmatism on modern maternal practices. According to this theory, pragmatism deploys cost/benefit analyses in order to advance what Rayna Rapp has identified as a "quality control" orientation toward maternity (46), an orientation predicated on the production and preservation of healthy infant bodies.

In Part 3 of Viral Mothers, "Breastfeeding and Global Public Health: Denial, Choice, and HIV/AIDS," Hausman further complicates her discussion by situating infant feeding practices within the context of HIV infection. Here, Hausman examines the choice to breastfeed despite the threat of mother to child transmission (MTCT) as one shaped by circumstances far beyond the purview of the medical model. Modern paradigms of risk/benefit analysis and informed choice decontextualize infant feeding practices while presenting as "irrational" those practices which fall outside of the behaviors approved by medical experts. Hausman notes that the rhetoric of informed choice enacts a dangerous, all-or-nothing model, in which mothers either submit to medical authority, without reference to the situational context in which these choices will be enacted, or else abandon themselves to fate and circumstance, "victims of their resource-poor contexts and their own ignorance" (147). This duality between rationality and irrationality, between "good and bad" choosing, operates upon the same premise of disembeddedness that informs medicalized modernity in the global north. However, as Hausman argues, "[Mothers'] responses are logical in their own contexts and attentive to specific material and rhetorical realities. It is only through an acknowledgement of the cultural embeddedness of biomedicine in particular attitudes toward life and the body…that we can hope to understand what appears to be repudiation of what biomedicine offers as a response to HIV/AIDS" (147).

The five chapters of Part 3 endeavor to provide just such a contextualization of the circumstances in which infant feeding choices are made. Here, Hausman examines institutionalized denial of HIV/AIDS science in post-apartheid South Africa of the early 1990s, in which many of the fundamental tenets of modern AIDS research, from the disease's causation by the HIV virus to the possibility of mother-to-child infection through breast milk, were questioned or overtly refuted by government officials and social leaders. Hausman deploys this important insight to examine denialism's impact on breastfeeding advocacy strategies in the global south. She argues that medicalized modernity's refusal to acknowledge the context in which infant feeding choices are made has at times led to a dangerous, if unarticulated, tactical alliance between denialism and breastfeeding advocacy. The prohibition on breastfeeding for HIV+ mothers by the modern medical establishment of the global north fails to address the specific situations in which formula feeding will be practiced in the global south, such as the frequent lack of access to clean water on which replacement feeding depends and the dramatically higher mortality rates for formula-fed infants. As a result, Hausman asserts, mothers of the global south may find themselves compelled to adopt a denialist stance toward mother-to-child transmission in the absence of any viable alternatives.

Hausman concludes Viral Mothers with a chapter on "Informed Choice," which is a powerful reiteration of the need to re-contextualize infant feeding practices. She invokes the complex framework established in preceding chapters to affirm the situatedness of maternal practices, contexts denied and obscured by rhetorics of choice. This chapter, like Viral Mothers as a whole, makes an important contribution to the growing body of literature that seeks to reverse modern disembedding, restoring women to the complex, amorphous, and contingent sociocultural networks through which child care is practiced. Hausman argues that African mothers, in particular, are caught in a double bind, their feeding methods a contested battleground between breastfeeding advocacy groups that fear the wholesale abandonment of breastfeeding in the few remaining areas on earth where breastfeeding is normal practice rather than abstract ideal, and the efforts of researchers and physicians operating within the modern medical model to demand replacement feeding as a preventative for HIV mother-to-child transmission. Amid the camps' rhetorical, political, and social jockeying for supremacy remains a devastating reality: that replacement feeding dramatically increases an infant's chances of dying from endemic respiratory and intestinal diseases, while "customary" breastfeeding, a mixed form of infant feeding in which breast milk is supplemented by water and other foods, increases the likelihood of MTCT of HIV. Viral Mothers brings much-needed attention to the potent forces acting upon mothers and children, replacing the binary of rational/irrational choice through which medicalized modernity defines infant care practices with a model responsive to the ambiguous and contingent circumstances of maternity itself. Hausman's rich, nuanced, and compelling analysis articulates the covert frameworks that circumscribe women's behaviors, frameworks that naturalize women's submission to biomedical paradigms through rhetorics of rational choice, even as biomedicine denies its power via the supposed privatization of the body. Viral Mothers ends with an acknowledgment that, in the complex and conflicted contexts in which infant feeding is practiced, "it is unclear that one particular way forward is possible" (216). This call for maternal practices that are sensitive to the sociocultural environments in which they are performed is an apt conclusion to a sophisticated argument that situates maternity within a biomedical framework relying on dehistoricization as an instrument of power.

Nevertheless, Hausman's assertion that Viral Mothers is a book "less interested in how mothers imagine themselves than in those forces shaping their beliefs and experiences. …[a book] tilted toward the forces and away from the women themselves, toward understanding the myths and not women's responses to the myths" (6-7) is problematic insofar as it reifies the rhetorical constructs it seeks to interrogate. If a singular way forward is impossible, if empowerment rests upon purposeful and myriad reactions to highly contingent historical contexts, then eschewing women's situated responses to their environments threatens only to perpetuate their status as cultural imaginary. It is to be hoped that scholars working within disability studies and women's studies will take the important insights offered here as a significant starting point in understanding mothers' negotiation of these pervasive constructs. The increasing emphasis within these fields on the inter-dynamics of power, problematizing older presumptions of discipline as absolute, of a unidirectional relationship between the subject and the power/knowledge structure, would go far in correcting one of Viral Mothers' few weaknesses, namely, its inability to envision situation-specific alternatives, such as the construction of lactation suites and nurseries in schools and workplaces or the facilitation of exclusive breastfeeding programs to diminish the likelihood of MTCT. If we are to think our way beyond the frameworks of medicalized modernity, then further examination of the methods through which mothers actively navigate the structures which imagine and attempt to define them is required. Such a framework would allow us to configure ideology as negotiation rather than commandment, in which both subject and system exist in a fluid and reciprocal state of constant evolution.