It is perhaps predictable that a new book emerging from a long-term ethnographic study in Madagascar might focus on the significance of ancestors, customs (fomba), and taboos (fady) to Malagasy people. What sets Erin Nourse’s approach to these topics apart, however, is her steady focus on how this significance plays out not through the mortuary practices, spirit possession, royal rituals, or other practices through which so many Malagasy adults are well known to engage with ancestral orders but, rather, through what happens “at the most quintessential of new beginnings—the birth of a child” (6). Based on research carried out over several stays (one lasting nine months) in Madagascar’s northernmost city of Diego-Suarez (Antsiranana), Water into Bones offers a thoughtful account of how urban women manage the uncertainties of health, relationships, and affiliation during pregnancy, through birthing and recovery, and well into the complex work of orchestrating the early social lives of children.

Nourse sets the stage by presenting Diego-Suarez as a port that, for centuries now, has been assembling people, cultural norms, and religious traditions in ways that, by 2011–12, had made it a place of “interfaith relationships and marriages across various ethnic groupings” (15) in which pregnant women and new mothers juggle the advice and expectations of interested others with their own understandings of, and uncertainties over, what might be best. As the book proceeds, it is these women and their stories and perspectives that stand out, offering readers glimpses of new motherhood shaped not just by ancestral customs, taboos, and ritual, but by capricious in-laws, the care of fellow women, experiences of an underfunded healthcare system, and, of course, both love for children and struggles with the anxieties they bring. We are introduced to Nasreen, for example, whose experiences of abandonment as a child led her as an adult to a religious community in which she, her husband, and their children have found security and support, manifested in no small part through post-partum bathing and the ritual first cutting of her children’s hair. We also meet Amélie, a graduate student whose unexpected first pregnancy brought on mixed feelings, peer pressure, and a deepening relationship with her child’s father’s family. In these and other accounts of women living through pregnancy, birth, and early motherhood, we come to appreciate how “Malagasy parents live in a complex world of competing religious and medical ideas about how best to raise healthy children,” and, more specifically, how mothers navigate “these worlds not without difficulty but creatively nonetheless and with the futures of not only themselves but also their children in mind” (204).

Nourse covers a lot of ground, combining women’s stories with discussions of the ritual practices and taboos through which they, along with their partners, infants, and young children, become connected to overlapping living communities and the ancestral orders from which they receive blessing. But she also addresses what some might overlook—the ambivalence some women feel to these orders, the kinds of behavior they demand, and the futures they portend; women like Marie for whom “ancestral commitments are not always of utmost importance in decisions about how to raise a child” (184). Whether followers of Christian movements that represent traditional Malagasy practices as sinful or, like Marie, the children of parents who had renounced ancestral practices in the name of enlightenment, these women represent a growing segment of the city’s population, indicating how Diego-Suarez’s remains, and will go on being, what it has long been—that is, a place in which parents (and mothers especially) face “the tension between the maintaining of traditions to preserve the moral order and the invention of new traditions in order to construct a new future that makes the parenting of young children, and indeed all of life, so complex” (205).

This book will be of interest to specialists of Madagascar, the anthropology of childbirth and motherhood, and contexts of religious hybridity. Written in accessible language, illustrated with photographs, and featuring compelling accounts of women’s experiences of pregnancy, childbirth, and post-partum rituals, it is certainly appropriate for teaching at all levels.