In A History of Family Planning in Twentieth-Century Peru, Raúl Necochea López provides an important critique of the application of demographic transition theory to explain changes in population size, preferences for smaller families and the increasing acceptance of family planning services in twentieth-century Latin America. Initially developed to elucidate why, in contexts like nineteenth-century Europe, a shift took place from families with large numbers of children, whose labour was seen as an asset, to families with fewer children, whose needs were viewed as financial burdens, demographic transition theory proved inadequate to explain the cases of Latin America and the broader developing world, where these shifts occurred much later. Beginning in the 1960s, scholars therefore attempted to adapt the theory to a Latin American context by building on its causal framework, which emphasised the effects of industrialisation, urbanisation and modernisation on decisions about family size. They reaffirmed demographic transition theory's core claim that financial calculations motivated parents to limit and space births and identified the 1960s as the pivotal decade in Latin America, in which such preferences for smaller families presumably began to appear. Moreover, they argued that this reduction in the birth rate was facilitated by growing access to biomedical contraceptive technologies for women and suggested that the United States served as a hegemonic force, which exported a nuclear family ideal and technical expertise to Latin America.

Focusing on the case of Peru, Necochea complicates this account by arguing for a deeper exploration of the history of family planning, one that rejects prevailing assumptions about periodisation and emphasises the role of local actors of various kinds. Indeed, an achievement of his book is its nuanced assessment of how family planning debates cut across Peruvian society on the ground, as ordinary people and others confronted questions of reproduction, child rearing and appropriate family size. These debates, Necochea convincingly demonstrates, were not simply brought to Peru from abroad. Rather, they took place and changed over the long sweep of the twentieth century in Lima and elsewhere, requiring an analysis that rejects the 1960s as the only significant decade of change. By meticulously reconstructing how a wide range of men and women experienced and participated in conversations about the healthy family, the provision and use of family planning resources, and the development of family planning policies, organisations and movements, Necochea challenges assumptions and understandings of how and when family planning and smaller families came to be seen as acceptable, important and necessary.

Necochea's analysis is especially valuable because he shows that family planning came to mean something quite different in Peru from what experts in demographic transition theory and women's history might assume. He attributes this to the participation in family planning debates of both conservatives and leftists, the active intervention and shifting position of the Catholic Church on family planning matters, the political priorities of military and civilian governments, and the contested influence of the United States and international organisations. For many Peruvians, family planning came to signify the development of the ‘well-constituted family’ through proper birth spacing, contraception, good parenting and female domesticity. As such, it did not consistently connote population control and economic development, nor did it mean the empowerment of women through exercising control over their bodies. Necochea's work thus enriches substantially our understandings of gender, sexuality and the family in Peruvian history.

A History of Family Planning in Twentieth-Century Peru contains six thematic and roughly chronological chapters. Chapter 1 surveys physicians' and officials' ideas about eugenics in the first half of the twentieth century, arguing that such figures saw changes in reproductive behaviour, safe birthing practices, proper parenting, and the control of vices as key components of building a healthy and productive nation. Chapter 2 analyses the work and legacy of Irene Silva de Santolalla, a Peruvian senator and conservative proponent of family education, who sought to create ‘well-constituted families’ by training wives and mothers to embrace female domesticity and become models of responsible parenting. Breaking with the biographical approach and emphasising ordinary people's experiences, chapter 3 examines the illegal practice of abortion in Peru. Necochea uses criminal cases to reconstruct the meanings society ascribed to abortion, the myriad reasons women themselves took action to end their pregnancies and the relationship between abortion providers and others involved in family planning. Chapter 4 reconstructs the experiences of health workers who embraced family planning and gradually came to support access to birth control by mid-century, resulting in the development of a provider-led model of family planning services by the 1960s that reinforced experts' power while failing to seek input from the women they assisted. Finally, Chapters 5 and 6 analyse the roles of civilian and military governments and the Catholic Church in developing and promoting family planning. Necochea argues that while governments focused on smaller families as the key to furthering socio-economic development and sought to mediate the influence of international agencies, the Church assumed the position in the 1960s that contraception did not contradict religious teachings if it was used to space births properly and thereby create better constituted, more stable family units.

Although Necochea's intervention in demographic transition theory merits the attention it receives in the book's introduction, some readers may wish he had more deliberately highlighted other contributions the book makes. It particular, Necochea's analysis significantly enhances our understanding of public health and the work of medical professionals under the Odría and Velasco dictatorships, as well as the civilian governments that ruled at mid-century. Its contributions to understandings of gender, sexuality, race and class in Peruvian society are likewise noteworthy. Finally, some readers may also wish that Necochea had discussed in greater depth in the book's epilogue the cases of coerced and forced sterilisations in the 1990s that framed the introduction, as this would add to the political import of his analysis and its relevance for recent Peruvian history. None of these concerns, however, diminishes the importance of this beautifully researched and engaging contribution to Peruvian history, the history of medicine and the history of family planning.