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A forthcoming book · Janet Perkins, MD

Unseen,

Unheard,

Undone

American women are suffering through pregnancy and birth — and being told not to worry about it. After 30 years as an OB-GYN, I'm done staying quiet.

STAY INFORMED

READ THE PREMISE

2–3 x

Higher Maternal Mortality vs. Peers

36%

Of US Counties Have NO Maternity Care

1 in 5

Women Experience Perinatal Mental Illness

THE BOOK —

The system isn't broken. It was built this way.

Unseen, Unheard, Undone makes the case that America's maternal health crisis is not a failure of medicine — it is a policy choice. Profit, policy, and the quiet acceptance of suffering have combined to create a system that regularly fails the people it promises to protect.

Drawing on three decades of obstetric practice, global health work in Haiti and beyond, and the stories of patients who were dismissed at every turn, this book names the crisis with precision and demands the reckoning it deserves.

This is not a book about bad doctors. It is a book about a broken system — and what it will take to fix it.

THREE CORE THEMES —

Theme 01

Profit Over Outcome

Financial incentives have reshaped maternity care in ways that consistently harm patients — from unnecessary interventions to the collapse of rural obstetrics.

Theme 02

Misdirected Policies

Well-intentioned legislation and hospital protocols have often failed to reach the women who need them most, while ignoring the root causes of disparity.

Theme 03

The Normalization of Suffering

American medicine has trained generations of women — and their providers — to accept pain, dismissal, and inadequate care as simply part of becoming a mother.

THE STORIES BEHIND THE BOOK—

Women kept telling me the same things.

Over thirty years, I have listened to thousands of women describe their experiences of pregnancy,

birth, and the postpartum period. What follows are composite portraits — real patterns, real words.

"I told three different providers about the pain. Every one of them said the same thing: some discomfort is normal in pregnancy. It wasn't until I went to the ER that anyone took me seriously."

First-time mother, rural New England

"After my baby was born, I felt like I disappeared. All the attention shifted to the infant. No one asked how I was sleeping, how I was feeling — anything. I was just a body that had done its job."

Mother of two, urban medical center

"My nearest labor and delivery unit closed while I was seven months pregnant. I drove 48 miles to deliver. I never felt more invisible to the system that was supposed to care for me."

Patient in a maternity care desert

"I knew something was wrong. My instincts told me. But I kept being reassured. Later I learned that other women on my floor that same week had the same experience. We all just accepted it."

Patient, postpartum complication

About the Author

Thirty years of listening to what women are told to ignore.

Janet Perkins-Howland, MD, FACOG is a board-certified OB-GYN with more than three decades of clinical experience, including service as Medical Director for Perinatal Optimization and Simulation at Wentworth-Douglass Hospital in New Hampshire.

Her work extends far beyond the delivery room. Through the Haitian Health Foundation, she has led medical missions to Haiti over many years. She has studied postpartum care systems internationally, including research in South Korea. She is a tireless advocate for maternal health policy at the state and national level.

—Board-Certified OB-GYN · MD, FACOG

—Medical Director, Perinatal Optimization & Simulation

—Global health work — Haiti, South Korea, and beyond

—NH maternal health legislative advocate

—Peace Corps · Northeast Thailand, 1985–1987

MD, facog

Janet Perkins

OB-GYN · Author · Advocate

"I have watched women suffer in ways that were entirely preventable — not because medicine lacked the answers, but because the system was never designed to prioritize their wellbeing."

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