In An Open Secret, historian Natalie Kimball “wrestles with an uncomfortable and slippery notion—that of unwanted pregnancy (embarazo no deseado)” (p. 113). The book's thesis—that the material and affective conditions that lead a person to regard their pregnancy as unwanted often elude conventional categorization—destabilizes several assumptions around reproductive behavior in urban Bolivia between 1952 and 2010. Kimball's oral histories with El Alto and La Paz residents in the early 2000s demonstrate how few women reflect on their pregnancies in such circumscribed terms. The causes of reproductive behavior are quickly revealed as too nuanced for frameworks of choice and rights as well as some of the structural observations on which feminist scholars have typically relied. Rather, in Bolivia, where abortion remains almost completely illegal, bearing a child is tied as closely to interpersonal and financial networks as to legal and political systems. More familiar is Kimball's argument that pregnant people have always looked for ways to negotiate their reproductive lives and have utilized political openings to achieve expanded, though limited, access to reproductive health care.According to state data from 2008, over one-third of pregnancies in contemporary Bolivia are unwanted, and most of these are carried to term. Yet the majority of Kimball's interlocutors described continuing their pregnancies not as an outcome of choosing to do so but as an obligation or necessity. Moreover, those who went on to have children expressed ambivalence but not complete regret. These layered responses guide the organization of An Open Secret. After tracing the history of reproductive policy in Bolivia, Kimball examines accounts of reproduction and abortion from medical personnel, police, and religious officials—many of whom have maintained public disapproval of abortion—before assessing women's own complex perceptions of their pregnancies. The following two chapters probe women's experiences with reproductive health care after the 1952 national revolution and into the military dictatorship and the democratic opening, respectively, which while markedly different were not entirely distinct. After the revolution, women “pushed the boundaries” of the state's pronatalist policies by continuing to terminate pregnancies (p. 149). Following the democratic opening in 1982, Bolivian women's groups organized for reproductive health-care access. Their activism and increased international support for abortion care were impetuses for the extension of public health insurance to cover pregnancy loss and expanded access to biomedical contraceptive support. Chapter 6 examines how legal mechanisms have failed both to prosecute people who have obtained illegal abortions and to facilitate access to legal abortions.Kimball's primary contributions come with their use of oral history as both a source and a lens through which to view the archive. Their conversations with 121 Bolivian women and men highlight the state's ongoing interest in reproduction and the role of structural forces on women's reproductive behavior, their “perceptions of what future was desired or possible” (p. 7). Even more, Kimball demonstrates the power of the social and affective on reproductive behavior. Their fieldwork never assumes the primacy of the individual woman; rather, each interlocutor represents a network of people, commitments, and judgments that make terminating a pregnancy possible or not. Kimball illustrates how the disruptions and especially the continuities of these interpersonal and systemic webs have influenced Bolivian women's experiences of their own pregnancies over the past half century.Beyond contributing to the growing number of country studies of reproductive politics and governance in Latin America, An Open Secret adds to examinations of the lives of urban Indigenous peoples and medical pluralism during neoliberalism. Particular moral frameworks abound in the adjacent and “inextricably linked” El Alto and La Paz; the majority Indigenous and poor populations encounter more pronounced antiabortion stigma amid the religious and patriarchal dynamics of urban Bolivia than in the surrounding rural areas (p. 18). Moreover, Bolivia's recent incorporation of some Indigenous health-care methods into the national health system and women's continual utilization of Andean birth control and abortifacients offer a unique context in which to trace the relationship between biomedical and Indigenous health systems.An Open Secret makes a case for narrative accounts as essential data for interpreting statistical and archival studies about how individuals navigate the complex avenues of reproduction. Moreover, Kimball's use of oral history elevates the intimate experiences of women as explicitly political. The book's lack of concise conclusions is not so much a problem of the text as it is reflective of the realities of this still forward-thinking task. Kimball must err on the side of subject anonymity in a climate in which abortion is stigmatized and piece together stories that often must necessarily remain secret. Rather than detracting from the argument, these impasses add weight to a main point of Kimball's argument, that “women's experiences matter simply because they occur” (p. 3).