From the final decades of US slavery to the present, a powerful and illuminating history of a profound inequity: the special burden of infant care and loss experienced by Black women.

In the United States, Black infants are far less likely to survive their first year of life than white infants. Underlying this predicament is a history of profound loss and persistent striving, which has durably shaped Black life in America. Following generations of mothers, caregivers, laborers, and activists from the final decades of slavery to the present, Perilous Passages chronicles the intimate practices and collective strategies Black communities created and relied upon to sustain early life threatened by disease, inadequate medical care, and racialized harm.

Perilous Passages examines nineteenth-century domestic care practices that carried families through the violence of slavery and war, and traces Black eugenic ideas, the efforts of various grassroots movements, and myths and realities surrounding the 1980s panic over "crack babies." Health professionals, legal officials, and scientific experts exerted pressure, sometimes directly-as in antimidwifery campaigns-and sometimes more subtly, through life insurance practices that devalued Black life. Wangui Muigai shows that at every turn, authorities recast infant deaths as the fault of Black women, with ongoing impact on birthing experiences and outcomes. Still, Black women and their communities have always done more than bear loss. They have produced vital knowledge about its causes, trained in specialized care, developed networks of cradle-to-grave support, and organized to reform society in ways that safeguard children.

Centering Black women's experiences, Perilous Passages insists on visceral confrontation with the deadliness of American racism while also offering a powerful account of what makes life possible.