Throughout the era of slavery in the British West Indies, planters, physicians, and imperial and colonial officials alike repeatedly expressed their concerns regarding the health and reproductive capabilities of these colonies' African-descended population. Such fears were far from surprising, as the overwhelming majority of these men and women were enslaved, and thus their ability to work hard and to produce the next generation of labourers for their owners were of paramount importance to the islands' continued prosperity and stability. But, as Juanita De Barros shows in this widely-researched study, following the emancipation of the slaves in 1834, and for more than a century afterwards, similar concerns animated discourses and practices of medicine and public health throughout the region. Abolitionists hoped that the size and health of the freed people's population would prove that slavery had been not merely immoral but inefficient as a labour system, and landowners and public officials hoped to transform liberated Afro-Caribbean men and women from ‘unsanitary subjects’ to ‘sanitary citizens’ (p. 10) who would provide a docile and industrious workforce for the islands' plantations in freedom as they had under slavery.

De Barros focuses her attention on three British colonies which, ‘taken together, indicate the diverse colonial responses to the population questions of the late nineteenth and early twentieth centuries' (p. 5). Jamaica was the largest and most populous British West Indian possession, Guyana the testing ground of many state endeavours regarding social welfare and public health, and Barbados an alleged ‘Little England’ (p. 7), supposedly the most recognisably British of all the Caribbean colonies. In these communities, in the century which separated the era of emancipation from that of the labour unrest of the 1930s, De Barros examines official responses to questions of sexuality and reproduction, the persistent image of the Afro-Caribbean woman as an unfit mother, and the desire not only of London officials and local white bureaucrats but of the more affluent and educated members of local black communities to ‘uplift the race’ (p. 5). In five well-structured chapters, she explores interlinked questions of demography, infant mortality, reproductive health, and child welfare.

Within three decades of emancipation, British abolitionists were horrified to find that the population of the sugar colonies was falling, rather than increasing. While in reality this decline stemmed primarily from the difficult living conditions of many ex-slaves, exacerbated in the 1860s by a severe outbreak of cholera, many metropolitan observers interpreted it as evidence that these freedmen and women were unable to cope with the challenges of self-determination. Concerns about the security of the labour supply, De Barros argues, combined with belief in the alleged mental and moral inferiority of people of African descent, encouraged government officials, Christian missionaries, and physicians to intervene assertively in many aspects of public health and welfare, particularly those related to sex and child-bearing. These initiatives included dogged attempts to provide a sufficient number of British-trained white midwives to replace the Afro-Caribbean ‘granny midwives’, practitioners of folk medicine who were the preferred birth attendants of most black women, but whom whites saw as ‘filthy and ignorant and not far removed from the jungles of Africa’ (p. 69). Once babies were born, their health was to be safeguarded by the ‘baby-saving leagues’ which were established throughout the Caribbean to instruct supposedly ignorant and irresponsible black mothers on how best to raise their infants; again, it was white British women who were placed in positions of leadership. The reader may be amused by De Barros's account of the early twentieth century phenomenon of the ‘annual baby show’, a competition which awarded prizes in categories such as ‘best conditioned baby’ and ‘most sensibly-dressed baby’ (p. 121), but this seemingly innocuous enthusiasm for safeguarding children's welfare led to a belief that children born out of wedlock were inherently physically and morally damaged, and that their mothers should be sterilised (p. 167).

De Barros argues convincingly that these various initiatives should not be seen entirely as top-down solutions forced by the colonisers onto the colonised. Afro-Caribbean populations are depicted both as resisting these practices, for example by continuing to consult ‘granny midwives’ rather than British ones, and as supporting them by participating in child-welfare initiatives as a way to prove their own respectability and to raise the overall tone of their society. It would, however, have been worthwhile to have learned more about the tensions which may have developed between these Afro-Caribbean men and women and those whom they deemed to be outside the parameters of respectability. De Barros's study would also have been strengthened had she placed her material within a wider transatlantic framework, by comparing the public health and social welfare policies enacted throughout the British Caribbean with those deployed in relation to impoverished or non-white populations in the metropolis, and also in the United States, where many officials and medical researchers shared these concerns regarding African-American residents of the rural South. Readers may find themselves speculating about the connection between the negative evaluation of Afro-Caribbean women's sexual behaviour and the anxieties of Victorian Britain regarding the alleged menace posed by prostitutes, or about the desire of both British and American authorities to forcibly sterilise individuals whose moral or mental faculties they deemed insufficient. But despite these limitations in its scope, Reproducing the Caribbean is a wide-ranging and important book, one which expertly interweaves the histories of race, sexuality, medicine, and empire in a way which illuminates both the commonalities and the differences between the experiences of the highly diverse British colonies of Jamaica, Barbados, and often-overlooked Guyana. Juanita De Barros has produced a monograph which will be of significant interest to anyone interested in the social and political changes which the British Caribbean underwent in the century following emancipation, as well as to scholars of the history of sexuality, gender and public health.