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Behind a thatched hut, a birthing woman bleeds to death only minutes from "life-saving" maternity care. Author Rachel Chapman begins Family Secrets with the deceptively simple question, "Why don't women in Mozambique use existing prenatal and maternity services?" then widens her analysis to include a whole universe of cultural, political, and economic forces. Fusing cultural anthropology with political economy, Chapman vividly demonstrates how neoliberalism and the increasing importance of the market have led to changing sexual and reproductive strategies for women.

Pregnant herself during her research, Chapman interviewed 83 women during pregnancy and postpartum. She discovered that the social relations surrounding traditional Shona practices, Christian faith healing, and Western biomedical treatments are as important to women's choices as the efficacy of the therapies.