Sally G. McMillen has written an enthralling historical account of the childbearing and -rearing responsibilities that consumed, often literally, the lives of women in the Old South. She explores the social, political, and medical influences of the time—which led women to assume fervently the full responsibility for their “sacred occupation,”—and examines how a woman’s maternal role ensured her value within the family and the greater society. Along with intimate details that authenticate her study. McMillen provides telling statistics on the number of women who died in childbirth, the rate of infant mortality, and the incidence of other causes of death to mothers and their children during the first half of the nineteenth century.