Science
What the rise of the caesarean section reveals about pregnancy and childbirth in the U.S.
Book Review
Invisible Labor: The Untold Story of the Cesarean Section
By Rachel Somerstein
Ecco: 336 pages, $32
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After Rachel Somerstein was rushed into an operating room for an unplanned caesarean section, her doctor made the first cut. “I felt that,” she told him. “You’ll feel pressure,” the doctor responded.
But, horrifyingly, Somerstein “felt it all: the separation of my rectus muscles; the scissors used to move my bladder; the scalpel, with which he ‘incised’ my uterus.” When her daughter was born, Somerstein was so traumatized that she couldn’t hold her baby. She screamed for her to be taken from the room.
Friends encouraged Somerstein to file a lawsuit; others balked, doubting that she could have undergone major abdominal surgery without anesthesia. The overarching message to mothers who experience traumatic delivery in this country is to get over it. “How long did it really take,” one attorney asked the author, “five minutes?”
It’s a common refrain: Just be happy you have a healthy baby. The dangerous and potentially unnecessary interventions of medicalized childbirth are never called into question when the pain and trauma of the person giving birth are invalidated. Somerstein quotes two scholars of healthcare and science: “Something is visible [only] when somebody recognizes it as relevant.”
Propelled by Somerstein’s own experience, “Invisible Labor” is a thorough investigation of birthing practices grounded in misogyny, racism and other forces contrary to the well-being of mothers.
Somerstein illuminates the capitalistic drive to rush birth in American hospitals facing infrastructural and staffing deficiencies: “Compared with vaginal births, C-sections are more efficient. Particularly if they are scheduled, a hospital can do far more of them … in a day.”
The medicalization of childbirth, including the C-section, undoubtedly saves lives. But the dehumanization of those giving birth, and the erasure of their well-being and experience, hurts everyone. As “Invisible Labor” shows, the lack of attention and communication in the hospital setting can be fatal.
Somerstein delves into the history of the C-section, which was devised to help save both mother and child. It was quickly adapted by enslavers, however, in “a push to bring about more slaves. In the U.S., most early caesareans took place in the South, and they still do today; a disproportionate number of Black and enslaved women made up the subjects.”
The history of birthing in the U.S. becomes a means of grappling with the history of slavery, racism and eugenics. Once the C-section was in practice, doctors realized that they could also sterilize women of color and those deemed disabled without their consent. “ ‘Acabó la canción,’ said one woman sterilized at L.A. County Hospital in the 1970s. My song has ended.”
Rachel Somerstein
(Joe Lingeman)
Relying on essential feminist texts such as Adrienne Rich’s “Of Woman Born: Motherhood as Experience and Institution,” Somerstein amplifies the role of the midwife — and her removal from the delivery room, taking away a library’s worth of knowledge about birth and birthing people and placing them in largely inexperienced, male hands.
“Just as land gets colonized, so does knowledge,” Barbara Katz Rothman, a sociologist, told Somerstein. “By laying claim to birth, medicine established boundaries over who has authority to attend it.”
Shockingly, Somerstein’s research shows that the electronic fetal monitoring technology used in hospitals, known as EFM, is “notoriously unreliable.” Often, it reports a falling fetal heart rate or stalled labor when the baby and mother are perfectly healthy. But it allows doctors and nurses to tend to many patients, running from room to room and leaving patients alone. Doctors and nurses are trained in the technology instead of the skills of midwives, who know what to look for from extensive experience.
“When used on mothers who have not previously had a caesarean,” Somerstein writes, “EFM, according to one study, makes a person up to 81 percent more likely to have a C-section than mothers monitored intermittently.”
The C-section rate has grown and grown — to about 1 in 3 U.S. births — and “a C-section mom is about 80 percent more likely to have a serious complication, like needing a blood transfusion or an emergency hysterectomy.” Women of color and particularly Black women are more likely to have caesareans.
Speaking to Rei Shimizu, a social work researcher, Somerstein relates: “There’s an assumption in the health system … that nonwhite female bodies cannot give birth safely without intervention.”
“Obstetric racism is about white doctors being racist, but it’s also about doctors, white, Black, whatever, that when you’re expressing your concerns, they just don’t listen,” said Nicole Carr, a professor who spoke to Somerstein about losing her baby after her concerns about her pregnancy were ignored. “It’s a system that makes it so that when you go in and talk about your concerns, it’s almost like you’re not an expert in your own body.”
“Invisible Labor” does not claim that doctors or even medicalized childbirth is the problem. Rather, it’s a system that decenters our humanity and relies on technology and statistics.
“We believe this visual omniscience will fix the problem,” Somerstein writes. “And we discard or forget that events take place outside the frame, including what subjective, embodied knowledge can reveal.”
Women who experience traumatic childbirth are far more likely to suffer from postpartum depression, anxiety or both. Perhaps “attending to women’s pain could be rectified by the simple but radical decision to ask women how they feel and listen to the answer,” Somerstein writes. Instead of telling her “You’ll feel pressure” when he made the incision, her doctor could have asked, “Do you feel pressure?” or, even better, “Do you feel pain?”
Then again, what do we expect in a country whose Supreme Court struck down women’s bodily autonomy? As it stands now, an unborn fetus has more rights than a woman or girl in many states. To create a better system of childbirth for mothers, we have to believe that the rights and indeed the lives of pregnant people matter.
“Invisible Labor” clearly and compassionately blends scientific research and reportage with the personal stories of Somerstein and other women. Childbirth is painful, but with the right care, it can also ground us in our humanity.
Some of the most moving accounts of birth in “Invisible Labor” come from women who had the support of a doula or midwife. When Somerstein writes that “every woman deserves the touch of a midwife,” she is communicating that every person deserves someone who will listen to and validate their experience. This should be the first standard of care.
Jessica Ferri is the owner of Womb House Books and the author, most recently, of “Silent Cities San Francisco.”
Science
Video: NASA Announces Artemis III Crew
new video loaded: NASA Announces Artemis III Crew
transcript
transcript
NASA Announces Artemis III Crew
NASA announced the crew of Artemis III mission, which will fly to low-Earth orbit to test rendezvous and docking maneuvers with one or two lunar landers.
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“I am excited to welcome you as the next crew in the Artemis journey to successfully return to the moon — this time to stay.” “I’m honored by the role that I’ve been given. I’m also very humbled by the task in front of us. But first and foremost, I’m grateful.” “So with that, the Artemis II crew, comrade, hands you the baton. You got the controls.” “As you know, we had a significant anomaly at our Launch Complex 36A on May 28. We’ve redoubled our efforts and are moving forward.”
By Alisa Shodiyev Kaff
June 9, 2026
Science
Santa Monica Mountains’ last steelhead trout survived the Palisades fire — and even had babies
Scientists feared the Santa Monica Mountains’ last remaining steelhead trout were dead, smothered by debris flows unleashed by the Palisades fire.
But the endangered fish surprised them: A team of biologists recently spotted 30 of the rare trout — and 21 babies — in Topanga Creek.
“There was a lot of happy dancing in the creek,” said Rosi Dagit, principal conservation biologist for the Resource Conservation District of the Santa Monica Mountains, which works with public and private landowners to conserve natural resources.
That’s because the steelhead here are endangered, at both the state and federal levels. Once, they swam in most streams of the Santa Monicas, but their numbers plummeted amid overfishing and coastal development. Increasingly frequent wildfire has further stressed their habitat. Topanga Creek, a biodiversity hot spot, is home to their last known population in the mountains that stretch from the Hollywood Hills to Point Mugu in Ventura County.
The trout that were spotted, including this one, are part of a distinct Southern California population that’s listed as endangered at the state and federal levels.
(RCDSMM Stream Team)
The California Department of Fish and Wildlife spearheaded a complex mission to rescue trout threatened by the Palisades fire that sparked in January 2025.
Time was of the essence. The fire hadn’t yet been fully contained. But rain was on the way, which would sweep massive amounts of sediment from the denuded hillsides into the water. Fish are often killed this way.
Crews stunned the fish with electricity, scooped them up in buckets, trucked them to a hatchery and ultimately moved them to Arroyo Hondo Creek in Santa Barbara County.
Within days, Topanga Creek was choked with mud. Some assumed the fish left behind were goners.
But in March, the conservation district’s team found four. The following month, when water conditions were clearer, they saw more.
“These fish continue to amaze me,” said Kyle Evans, environmental program manager for the state Department of Fish and Wildlife, who had seen the damage to the creek. “I had seen populations get wiped out in similar situations. So when I heard, I was thrilled.”
Evans surmises the fish that survived were in an area of the creek where less charred material and sediment were swept in.
“These fish likely hunkered down, were hiding under some rocks or places to try to get away from the main concentration of flow,” he said. “And luckily they weren’t buried.”
The ones that were spotted were fairly small, around 6 to 14 inches. Rainbow trout and steelhead trout are the same species, but with different lifestyles. If the fish remain in freshwater, they’ll be considered rainbows. However, they can migrate to the ocean and become steelhead, where they typically grow larger before returning to their natal waters to spawn.
Topanga Creek hasn’t fully recovered from the damage it sustained, but scientists say it’s looking better. Surveys last year were “so depressing,” Dagit said, with very few animals, and stretches that were essentially transformed into flat roads from all the sediment buildup. Some of the riparian canopy burned right down to the creek.
Then came 32 inches of rain over the last nine months, scouring out and moving sediment, creating deeper pools. Dagit said they recently found newt egg masses for the first time in years, as well as a few adult newts and many frogs. Plants that provide cover are starting to recover.
She provided photos comparing certain pools last year and this year, some dramatically transformed. In September 2025, the Shrine Pool could have been an overgrown hiking trail. This April, it was filled with shallow water.
The Shrine Pool in September 2025, left, and the same location in April 2026, right, with RCDSMM’s Isaac Yelchin donning a wetsuit.
(RCDSMM Stream Team)
Topanga Creek is home to another endangered fish, the small but hardy northern tidewater goby, often described as cute. Not long before the trout operation, Dagit led a rescue of hundreds of these fish too. Many were repatriated to the lagoon at the mouth of the creek in a moving ceremony last June.
There’s still the matter of what to do with the trout that were moved to Santa Barbara County last year. Evans would like to bring them home to the Santa Monicas at some point, but isn’t sure if it will happen. On one hand, they could bolster the small, genetically isolated surviving population. On the other, they might inadvertently bring in a disease or bacteria. There is some time to decide. Evans estimates the creek still needs to recover for two to three more years.
For now, the fish are functioning fine in their adopted creek. Experts worried the trauma wrought by the move would disrupt their spawning process, but they had babies that spring. This year, they spawned again.
Science
Pacifica pier cracks, another coastal casualty as seas continue to rise
The Pacifica Municipal Pier was shut down and taped off Thursday after city workers noticed cracks running through the landmark structure and concrete chunks falling into the ocean.
It’s just one of many coastal California structures that have recently crumbled under pressure from a rising and relentless ocean.
Officials from the small, beach city south of San Francisco said the pier was closed due to “cracking, separation, and displacement of the concrete walkway and structural elements.”
It will stay closed while structural engineers asses its safety.
Photos taken by city employees show a wide crack that runs from top to bottom and across the structure as well. Other photos show a large horizontal crack under the foundation of a small restaurant on the pier, the Chit Chat Cafe.
The cafe was also shut down.
This is not the first time the 53-year-old pier has shown signs of stress. In 2021, part of it was shut down after handrails along the edge collapsed. And in 2023, after a series of storms pummeled the Central California coast, damaging parts of the pier, the structure was partially closed for more than year.
Those same storms caused extensive damage in Aptos and Capitola, 70 miles south, where piers and waterfront infrastructure were swept away or damaged.
In 2024, a 150- to 180- foot section of the Santa Cruz wharf was ripped off by powerful waves.
At least 10 of the state’s dozens of coastal public piers were closed for part or all of 2024 due to structural damage sustained in winter storms since 2022. At least five others have longer-term upgrades planned to address structural issues.
“These things are costly to maintain,” said Zach Plopper, senior environmental director at Surfrider. “They are a part of our California coastal culture in many ways, but we’re going to need to reckon with, one, the state that they’re in, and two, the continuous and worsening threats they’re going to experience,”
He said most of the piers were constructed in the early 1900s, and they weren’t built to withstand decades of rough seas, storms and rising sea level.
“With this incoming El Niño, which is forecasted to be significant, and this marine heat wave we’re in the midst of, we’re kind of in uncharted waters as far as what this winter could bring in terms of storms and swells to the California coast, and we’re likely going to see a lot more damage,” he said. “Not just piers, but roads and other coastal infrastructure up and down the state.”
There was no storm in Pacifica earlier this week, so no single event could be blamed for the destruction.
However, a 2025 report from an outside engineering firm, GHD, found that several sections of the pier were in “poor” or “serious” condition, and they recommended closure before anticipated storms or events that could “subject the piles to high winds, swells and large waves.”
The firm found several areas of the pier where concrete was missing and rebar was exposed and corroding.
“The pier has continued to experience high winds and large waves in a harsh marine environment,” the engineers wrote in the report, noting that continuous exposure to seawater or marine spray was “detrimental” to the structure.
A 2023 city report estimated it would cost $19 million to repair.
That same year, a state law was enacted to require local governments along the California coast to plan for sea level rise in the coming decades.
Sea level has risen some 8 inches, on average, along the coast in the past 150 years, Plopper said, and researchers anticipate another foot in the next 25 years.
“We’re going to see profound shifts on our coastline, none that we have ever experienced before, and building static structures on the coast just doesn’t work all that well,” he said. “We’re going to have to make some really hard decisions.”
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