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Labor: One Woman's Work

Autor Dr. Mary Fariba Afsari
en Limba Engleză Hardback – 7 mai 2026
A powerful memoir of medicine, identity, and family secrets from an esteemed ob-gyn as she unravels her grandmother’s mysterious death while reimagining women’s health care from a mobile clinic—for readers of The Beauty in Breaking and The In-Between.

In Labor: One Woman’s Work, Dr. Mary Afsari takes us on a deeply personal and transformative journey through her life as an ob-gyn. Set against the vivid backdrops of Portland, Oregon, and Shiraz, Iran, this powerful memoir intertwines the complexities of her professional life with the hidden truths of her family’s past, exploring the intersection of medicine, identity, and the enduring search for agency.

The story begins in the bustling corridors of an Oregon hospital, where Mary dedicates herself wholeheartedly to her patients—often at great personal cost. At the same time, Mary uncovers a long-buried family secret: the tragic story of her grandmother Mehry’s death in 1950s Iran. This revelation propels her on a quest to untangle the threads of her family’s history while confronting the forces that have shaped her identity and her professional mission.

As Mary struggles with the oppressive realities of the medical-industrial complex and the growing attacks on women’s reproductive rights, she chooses a path of bold defiance. Inspired by her grandmother’s legacy and her own commitment to compassionate care, she decides to take her work out of the hospital and on the road: she converts an RV into a mobile women’s health clinic. This innovative act allows her to deliver personalized, critical reproductive health care services across the Pacific Northwest, creating community and enduring friendships along the way.

“When women don’t have a choice, bad things happen,” Mary writes. Labor is an intimate, immersive personal story, a rallying cry in a post-Roe world, and an inspiring example of what women can do when they do have a choice. Rich with the voices of her patients and the vibrant cultural threads of her Iranian heritage, Mary’s story challenges us to rethink the boundaries of health care and reclaim the autonomy of women’s bodies and lives. With warmth, insight, and humor, Labor ultimately offers a vision of transformation, resilience, and the power of reclaiming one’s path and saving other people’s lives in the process.
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Specificații

ISBN-13: 9781668015407
ISBN-10: 1668015404
Pagini: 224
Dimensiuni: 140 x 213 x 18 mm
Greutate: 0.31 kg
Editura: Avid Reader Press / Simon & Schuster
Colecția Avid Reader Press / Simon & Schuster

Notă biografică

Mary Fariba Afsari, DO, is a board-certified ob-gyn who founded FemForward Health in Portland, Oregon. She graduated from the University of Connecticut School of Medicine Obstetrics and Gynecology Residency and also holds a MS in health communication from Tufts University/Emerson College. She is the author of Labor: One Woman’s Work.

Extras

1. Mermaid Hair: 2018

Mermaid Hair 2018


Three of my medical assistants sit me down at the end of the day. We are in our break room surrounded by bulletin boards covered with photos from our most recent office party.

“So, we’ll put half of your hair up out of the way and just work on the back half, right?” Alycia is in charge of the operation. She’s lost seventy pounds over the past six months through a diet of fasting, candy, and tequila after learning her husband has another wife and family in Guatemala. This left her mascara-stained on certain days and near asleep on others. I scold her when she is down and rejoice when she is back up. She provides me with a secret drawer of Jelly Bellies, gummy bears, and strawberry bubble gum that I sneak in between patient visits.

“Right. Aqua streaks. Pops of fuchsia.” I lean back in the chair. “I trust you.”

The other two women bounce around the room with phones in hand. They are taking photos, posting on Snapchat and Facebook. I imagine the caption: “Giving our doctor mermaid hair!!”

A few days earlier I spent an especially pernicious bout of insomnia scrolling through pictures of women with hair dyed various shades of hot pink, turquoise, and purple. My long, brown hair has recently grown out a light-colored balayage and the ends are turning blond in the summer light. Perhaps color might ignite a spark of magic into my forty-something, doctor-mom life.

It takes about twenty minutes. The team fastens a paper sheet—the kind we use to cover naked laps during pelvic exams—across my chest. Alycia is a self-proclaimed amateur hair-and-makeup artist. She knew exactly which tubes of dye to purchase when she ran to Sally Beauty Supply over her lunch break, and now she pins up the front sections of my hair with authority. As she applies color to the long strips of hair falling around my shoulders, drips of pink and turquoise and a purplish blend of both stain the front of the paper sheet. I surrender all control. I am usually the one in charge, and right now it feels good to hand it over to her. After the color is in, the group takes a final photo. I stare at the image on the phone screen. I look like a cartoon-character version of myself, with half my hair pulled up in front and a rainbow of hair, wet and pungent, splayed across my chest.

I try to smile. This picture captures my internal midlife chaos in one unfiltered shot.

“Go straight home, Doctor A.” Alycia laughs. “Hope you don’t get called to the emergency room!”

The other two chime in with instructions—wait forty-five minutes, then rinse off in the shower. Use deep conditioner.

“It’s gonna look great!” they call after me as I head out the door. I hear their laughter behind me and head to my car. It is well past six o’clock. I am hungry and tired and unable to stop at a grocery store looking like this. I get into the driver’s seat and glance in the rearview mirror.

I look like a crazy person, I think. The summer has been one of growing anxiety. New strands of gray at my temples brought with them so many uncertainties and intimations of regret. I question my decision to become a doctor every day. Lately, I even consider leaving my career. This brings late-night panic attacks and long talks with my husband, closest friends, and not one but two therapists. For about a year now, unbeknownst to most, I have been in crisis.

“Mermaid hair.” I angle the rearview mirror to point at my colored streaks. Like so many of my spontaneous ideas, it now feels frivolous and ridiculous. I wonder how quickly I can get home to wash it out before it sets.

The drive between the office and my home is the equivalent of a cleansing bath. With my days spent in total engagement with patient after patient, and the nature of my job one of unpredictable needs and heightened emotion, I relish the solitude of my twenty-minute drive home.

I turn out of the parking lot and the smell from the hair dye is profound—an attempt at floral essence to hide the strong chemical undertones. I know I am frying the bottom half of my hair with every passing minute, but fried hair is low on my list of concerns. Hair can be cut and reinvigorated in an instant. That is nothing compared to the invasive surgery I am scheduled to perform tomorrow. Or the disappointment my daughter feels when I miss her summer camp performance to deliver a baby. Or the diminishing returns my husband is certain to be feeling in our decade-plus-long marriage, where energy pours out of me all day and I require quiet and replenishment every night.

Yes, I could chop off the ends of my hair and there would be a momentary regret because, yes, I had spent the past year growing it to this long, sexy-in-her-forties length. But I know, from Deepak and Oprah and Eckhart, that everything is temporary, including the stuff that does not really matter—and also the stuff that matters most.

I am only two miles and a few minutes from the office when traffic slows ahead. I press on the brakes and roll down the windows to clear the air of dye. This slowdown is a little unusual. I creep the car forward, looking at stopped traffic on both sides. It only takes a few seconds for me to discover the reason. In the opposite lane, the side of oncoming traffic, I see a motorcycle lying sideways on the road, and next to it, the body of a woman. A quick glance around confirms—no ambulance, no fire truck, no police car. The accident just happened, and aside from a couple of bystanders hovering over the body, there are no first responders on the scene.

It is a moment doctors talk about: the instant, on the freeway, or on an airplane, when an emergency occurs and Good Samaritan laws kick in. When the request is made for a doctor to “ring their call light.” A good friend of mine who is a seasoned anesthesiologist says in those moments he asks himself, “Am I a doctor? Because nobody will know if you decide you’re not.” I always laugh when he says this because the question of whether I am a doctor never crosses my mind in an emergency. Every other minute of the day I question my doctor-ness, but in dire situations—such as a body on the road—there is no question. Right now, I see a woman on the road and nobody around to help. I am also dressed like a person who believes she is a superhero, complete with paper cape and colored, dripping hair. I am not going to make it home for the forty-five-minute rinse and conditioner.

I stop the car and make the snap decision to rip off the paper sheet. I allow the color to simply drip, and I am aware of the matching bright-colored stains on the front of my shirt. A bystander has a 911 operator on speakerphone when I approach.

“I’m a doctor,” I say quickly. “Do you know what happened?”

I speak while I move, and I move quickly. The mind-to-body connection of most physicians is quick. We can talk and move and think faster when necessary. We can observe what is right in front of us, take in our surroundings, and process multiple conversations at once. I do not know this about myself in a conscious way, only in retrospect. Thinking back to those first few minutes on the accident scene, I am acutely aware of the row of teenagers and young children on one side of the road—family members of the opposing driver. I clearly see the body-sized indent in the passenger side of the vehicle that was turning onto a driveway. I take account of the anxious, determined tone of voice of the bystander who called 911. I note a helmet flung to the side of the motorcycle—a light pink-and-gray pattern decorating the cap. And finally, I look down at the body on the road: a tiny-framed woman with long, light hair, straight down her sides. She wears jeans that I register as a size zero. A smoker’s frame, I think immediately. A skinniness invoked by nicotine and few calories. I kneel next to her right arm and immediately feel the adrenaline leave my system. It is obvious to me that she is dead. The only color in her face is the dark-red blood frothing from her lips. Her eyes are open but fixed and gazing to the sky. I reach to check a pulse, aware that all eyes are on me and what I do next. I may not look like a doctor right now, but I just proclaimed myself as one.

“Start chest compressions,” the 911 operator announces over the speakerphone being pointed toward me.

There is no pulse, and I know the futility of compressions in the moment. But children are standing on the side of the road, and a woman is holding a phone over me, and there is a body of someone’s daughter under my hands. How old is she? I think this several times and cannot tell. There is no color to her hair or skin to indicate. She could be thirty or seventy and it does not matter. I clasp hand over hand, find her sternum, and begin compressions.

One, two, three…” The woman on the other side of the body counts my compressions in a loud, firm voice. She informs me that she is a medical assistant and has basic life-support training. She is earnest and determined. If there is a heartbeat to bring back to life, she will make sure it happens. We get to thirty compressions, and she offers to take over. I sit back and let her.

Thirteen, fourteen, fifteen,” she is counting out loud, and I recheck for a nonexistent pulse. This was death upon impact—I have no doubt in my mind.

The 911 operator instructs us to give rescue breaths. I look at the ashen face and think, between the blood, the asphalt, and my hair color, this stench will now always be a part of my sensate memory. I’ll never be able to smell blood like that again without smelling asphalt. I will never be able to smell hair dye leaving the tube without smelling the blood.

“No, no breaths,” I tell the woman across from me. I had cooperated with compressions with a sinking nausea, knowing that there was no bringing this woman back to life. But breaths? No breaths.

“She has no pulse,” I say out loud to the phone. “She has blood coming from her mouth,” I emphasize. “No pulse,” I repeat.

The voice on the phone pauses and then relents. “Okay,” she agrees, no breaths.

We hear the ambulance sirens approach and within seconds we are surrounded by paramedics, firefighters, and a stretcher.

“I’m a doctor. I’ve been here for several minutes,” I tell the approaching men.

My face, neck, and shoulders are now covered in purple and pink dye, while my hands and arms are stained with dirt and flecks of blood.

“Fixed pupils, no pulse, she was dead when I got here,” I say firmly. I have been around enough bodies, alive, and fewer bodies, dead, to know the energetic truth. I had done chest compressions on this woman’s shell. Her essence was gone before I arrived.

The paramedics acknowledge that there is nothing more to do. A quick hookup to the heart monitor confirms absent electrical activity. And yet they still do a look around, make eye contact with the two of us huddled around the body.

“We all agree there is nothing more to do?” One of the men glances at each of us, as if we could change this fate. But we nod and a yellow sheet is unfolded.

I am not sure what I expect to feel in the moment, but I do find myself still collapsed on my knees. The medical assistant kneels next to me. The sheet is drawn, and we place hands on the dead woman’s legs. One hand on her, one arm around each other. I bow my head while the assistant recites a prayer. The words do not matter. The actual prayer is just a hum in my ignorant ears. But the sentiment, the stranger circle we form to bless and offer peace… that I can understand. In that moment, the body under the sheet could be anybody.

The palm of my hand rests on this body’s thigh. Mehry? My fingers dig in a little bit; the woman to my left squeezes my shoulder. Where did you go?

Footsteps behind our group break us out of our vigil and my head pops up, my hand releases.

“You’re the doctor? Right?” The police chief approaches.

I give a nod and a shrug as if to say, “Yup, that’s me. Yup, a lot of good that did. Yup, the hair thing. Yup. Yup. Yup.”

“Thanks for the help. No questions for you. You can go.”

I drive home in the slow lane, barely reaching the speed limit. The evening light glows with a neon tint, and I put on sunglasses. The brightness is a contradiction, the sun an insult to the covered body one mile back. Shouldn’t the world go dark for just a moment? Shouldn’t we all pause?

My hands on the steering wheel are surface-level clean from the antibacterial soap I pumped onto my palms before I left the scene, but the rest of me is covered in remnants of the accident. I know I will strip all my clothes off on the back porch before entering the house. These are clothes I will drop directly into the trash. It won’t be the first time.

I dial Alycia on speakerphone. I need to talk to the last person who saw me leave the office, mermaid-hair dream in full effect.

“You’re not going to believe what happened,” I yell-speak to the empty car.

I describe the traffic slowdown, the body on the road, my first-responder dilemma, the pink dye staining my shirt. She gives me the sympathetic gasps I need in between sad and nervous giggles. I hang up the phone and the car is silent again.

On normal days, I bask in the silence of my car. Right now, though, I am just lonely, and the loneliness invites in all the memories. I am four years old with a foreign name and nobody invites me to their birthday. I am in seventh grade eating lunch with the librarians. I am waking at two in the morning, sneaking out of the house, quietly starting my car, driving on an empty road to the hospital. I am pumping milk in a corner room, staring at a picture of my newborn. I am surrounded by loved ones, family members, lifelong friends, and my mind is not in the room. My body is the empty shell of the woman. The woman back on the pavement was empty when I arrived. My face has a fixed look. Her last expression was already gone. My smile these days is the upturned pencil line drawn by my daughter when she sits down to color.

I stop at traffic light after traffic light on the seven-mile road home, where apartment buildings become bungalows and trees start to appear next to sidewalks. Numbness is ninety percent of my body, and I try to remember when numb became my new normal. There was a time, I know, when an experience like this one—the encounter with sudden death, the all eyes on me, the futility of my efforts—would leave me shaking and sobbing, overwhelmed with emotion, puffy-faced, and dripping. Nowadays, I clench my back teeth and breathe through my nose when sadness arises. Even now, in the private confines of my car, nobody to see, no person to judge, I cannot summon tears. I stare straight ahead, pay closer-than-usual attention to pedestrians and traffic lights, and feel only the slightest tremble in my body.

The car is too quiet, and I am still ten minutes from home, so I dial my brother, then my best friend, and, finally, my husband. I brief them quickly. I absorb their sympathy. I alter the story of the motorcycle accident each time. My hair gets more color. The children on the road multiply. The stench amplifies. But the facts remain the same. The body is unmoving when I approach. The ribs crack under my compressions. The blood from the lips turns darker with each minute.

It is days later when I learn that the woman on the road was sixty years old. She was a mother, a gardener, and a flower enthusiast. She had wanderlust. She was also a grandmother. Mehry? She held her grandbabies close. Knowing these details made me think she might have been amused by the story of the minutes after she died. She might have enjoyed knowing that the person who arrived at the scene of her death was also restless, full of wanderlust, and beauty-seeking. She might have appreciated that ninety minutes after she collided with an old sedan turning into a driveway, the doctor who stared into her unmoving pupils stepped into a shower and watched a brownish stream of water stain the tub. Towel-dried then blow-dried, the purple and aqua, pink and sea-green blended together to form a wave of psychedelic strands. She might have been happy to know: the mermaid hair—it turned out gorgeous.

Recenzii

"Labor is a life-affirming testament to the hard work, determination, and heart one doctor puts into serving her patients. And throughout this moving memoir, the echoes of what our grandmothers endured reverberate with transformative power.” —Marjan Kamali, New York Times bestselling author of The Lion Women of Tehran

“Dr. Afsari has written something extraordinary. She masterfully weaves her grandmother's tragic death from lack of healthcare access with her own journey as an OBGYN, creating a story that feels both deeply intimate and universally important. What struck me most was how honestly she navigates the impossible terrain of being a ‘good doctor’ in a broken system, all while juggling career pressures, marriage, and the weight of a family legacy. Whether you're a healthcare worker who will see yourself reflected in these pages, or someone who has struggled to find compassionate care in our medical system, this book will move you. Dr. Afsari doesn't just tell us what kind of doctor she strives to be—she shows us, and it left me feeling genuinely inspired about what healing can look like when it's rooted in humanity and justice. This is the kind of book that changes how you think about medicine, care, and the stories that shape us.” —Dr. Jennifer Lincoln, author of Let’s Talk About Down There

"A stirring report from the trenches of women’s health care. . . . The frontlines of medicine have lent themselves to a long line of excellent memoirs, and they are now joined by Afsari’s gripping debut. . . . The personal history woven through the narrative begins with her grandmother, Mehry, whose tragic story is beautifully imagined, and includes a loving portrait of her father, who urged her to follow him into medicine, using both carrot and stick. . . . Since she’s no Picasso, she might as well go to med school. Well, thank heaven she did, most readers will conclude. . . . Joins the best medical memoirs with a moving personal story and a passion for the work." Kirkus Reviews, starred review

"Most medical stories focus on the what and the how—and Afsari’s descriptions of her interactions with her patients, including the procedures she per­forms for them, are detailed, engrossing and sometimes harrowing. . . . But what separates the good medical mem­oirs from the great ones is their focus on the why. Labor is certainly among the greats. . . . [Afsari's] RV is more than a clinic. It is her battleground, and like a knight-errant, Afsari girds herself each day, not with a sword and shield, but with knowledge, skill, compassion and a determination to pro­vide the health care that each of us deserves.” BookPage, starred review

“Thoroughly engaging and heartwarming, Labor is the inside story of a doctor reliving her family’s secrets as she navigates the dangerous landscape of providing comprehensive medical care to women in the tightening grip of criminalization and threats in America." —Dr. Eric Manheimer, author of Twelve Patients: Life and Death at Bellevue Hospital

 
"A brave book about pregnancy, birth, and how to best care for women in a time of high-profit health care. Afsari's story of offering OB/GYN care in a remodeled RV will surprise and inspire readers. Afsari understands the importance of meeting women where they are, with compassion, grace, and her own resolute clinical expertise." —Theresa Brown, RN, New York Times bestselling author of The Shift: One Nurse, Twelve Hours, Four Patients’ Lives and Healing

Labor is a journey deep inside the day-to-day realities of providing reproductive health care, with all its nuance and complexity. Reading this book is a meaningful reminder that we each carry the stories of the women who came before us, and that we have an enduring responsibility to the women who come after.” —Rebecca Grant, author of Access: Inside the Abortion Underground and the Sixty-Year Battle for Reproductive Freedom

“A must-read practitioner’s memoir for anyone interested in reproductive healthcare.” —Library Journal 

Labor is an unforgettable journey into the heart of medicine, motherhood, and memory.” —Dr. Neel Shah, Lecturer at Harvard Medical School and Chief Medical Officer of Maven Clinic

Descriere

For readers of The Beauty in Breaking and The In-Between, a powerful, rich, and urgent memoir of medicine, agency, identity, and family secrets from a superstar OBGYN providing personalized care from a tricked-out RV mobile clinic while attempting to unravel the mystery of her maternal grandmother's death.