Mother Tongue magazine, the biannual print magazine known for disrupting the motherhood media
landscape, has expanded its presence by releasing its first photo book. ‘Extreme Pain, Extreme Joy’ comes from award-winning Los Angeles-based photojournalist Maggie Shannon. This book is the first in a series of titles devoted to showcasing original perspectives on women’s stories that have been overlooked by mainstream publishers.
Released in December 2024, a month after the United States voted once again for a president who has been extremely hostile to women’s rights and reproductive freedom, and a month ahead of his second term in 2025 which began with actions that show his disdain for reproductive rights, this book and everything it represents couldn’t be more timely.
Maggie’s ‘Extreme Pain, Extreme Joy’ is both a celebration of birthing bodies and an intimate, candid depiction of what it means to care—her images demystify childbirth, reminding us that it is at once epic, and utterly ordinary. Her award-winning photo series began as a documentation of midwife-led home births after much of the US went into lockdown in early March 2020; now it is recontextualized in book form, with a foreword by author Angela Garbes (Essential Labor, Like a Mother), an artist Q&A with critic Gem Fletcher and a slew of never-before-seen images that together create a timeless meditation on this fundamental human experience.
Capturing the entire process of birth—the exhaustion along the way, the agony of the moment of, the surreal relief of the after and the lulls in between—Maggie’s images offer a rare view of mothers, becoming. The images also subtly reflect on the realities of childbearing and childrearing in America.
In a country that has one of the highest maternal mortality rates among developed nations and where Black women are three to four times more likely to die from pregnancy-related causes than white women, in a country that has no guaranteed parental leave, a dearth of affordable childcare and little support for mothers from the very instant they become one, these photographs are intimate meditations on the tireless strength of women and the raw beauty of that suspended reality, before the work really begins
There is a quiet, beautiful and intimate sense of power captured in the photos, a reminder that the birthing experience is so personal and unique to each person and family. The notion of it being controlled by an outside entity like the government feels so absurd, that the juxtaposition shown in Maggie’s images is its own act of resistance. We had the chance to speak with Maggie, and Mother Tongue magazine founders Melissa Goldstein and Natalia Rachlin, to learn more about ‘Extreme Pain, Extreme Joy’.
‘EXTREME PAIN, EXTREME JOY’ PHOTOGRAPHER MAGGIE SHANNON
When did you first begin working on ‘Extreme Pain, Extreme Joy’, and when did you decide to turn the photo series into a book?
I began working on ‘Extreme Pain, Extreme Joy’ in early March 2021 after a conversation with my friend Paige Schwimer, a doula in Los Angeles. We were discussing how the pandemic might negatively impact women, and she mentioned a potential rise in home births as mothers sought to avoid hospitals—especially with partners being banned from delivery rooms. That piqued my curiosity, so I started calling midwives across the country to understand how their practices were shifting.
What I found was striking: midwives were overwhelmed with requests from new clients desperate to give birth outside of hospitals. Their stories felt urgent and important—what does it mean to give birth amid such chaos and rapidly changing medical protocols? Midwives invited me to follow them on home visits and introduced me to women who were open to having me document their births. That’s where the project truly began.
I’ve always loved photo books, so the idea of turning this series into a book was in the back of my mind from the beginning. The process of transforming hundreds of images into a sequence and then into a physical object is something really special.
What was the process of finding the midwives you followed, and how did you gain the trust of the birthing women you captured so intimately?
Gaining access to these intimate spaces required a great deal of trust, and I’m incredibly grateful to the midwives and mothers who welcomed me in. The midwives I worked with would share my contact information with mothers who were open to having their births documented. From there, I’d connect with them over the phone and, whenever possible, meet in person to explain my process and the vision behind the project. Building that trust was essential—it was important to me that they felt comfortable and understood my approach before inviting me into such a deeply personal moment.
Given it was the height of the pandemic and there was so much uncertainly around health measures generally, what were the biggest challenges for you following your subjects of this series?
Keeping myself and my husband safe was my top priority. In the early days, before it was widely understood that COVID was primarily airborne, I followed a strict decontamination routine after every shoot—wiping down my gear, washing my clothes, and immediately showering. The fear of unknowingly bringing the virus home was always in the back of my mind, adding another layer of stress to an already intense project.
Why did you decide to publish these images in black and white?
I chose to publish these images in black and white because birth is such a timeless act, and I wanted to reflect that sense of continuity. Stripping away color allows the focus to remain on the raw emotion, light, and form within each moment, emphasizing the universality of the experience. I was also inspired by the documentary style of the FSA photographs and Eugene Smith’s Country Doctor series—both of which capture intimate, unsentimental yet deeply human stories. The aesthetic of black and white felt like the right way to honor the weight and history of birth while keeping the images grounded in the present.
You embarked on this series before becoming a mother yourself. Now that you have your own child, do you look at this work differently? Can you share more about this?
Now that I’m a mother myself, this work carries even more depth and resonance for me. Before, I approached the project with curiosity and reverence, but now I feel the weight of every moment in a much more visceral way. The intensity, vulnerability, and raw emotion of birth—all of which I witnessed through my lens—are now deeply relatable on a personal level. I find myself revisiting these images with a new sense of empathy and connection, understanding in a way I couldn’t before just how profound and transformative the experience of birth truly is.
As someone who is clearly passionate about reproductive healthcare, given your photo series about an abortion clinic providing later abortions in MD, what are the connections between ‘Extreme Pain, Extreme Joy’, and ‘A Safe Haven for Late Abortions’?
I see ‘A Safe Haven for Late Abortions’ as a natural continuation of ‘Extreme Pain, Extreme Joy’—almost like part two of the same larger story. Both projects explore the deeply personal, emotional, and physical experiences of reproductive healthcare, whether it’s bringing a child into the world or making the decision to end a pregnancy.
At their core, they are about care, agency, and the profound relationships between patients and the providers who support them. The same tenderness, trust, and vulnerability exist in both spaces, and I was drawn to documenting the ways in which clinicians offer not just medical care, but also compassion, respect, and love in these pivotal moments.
‘Extreme Pain, Extreme Joy’ also feels like a snapshot in time when the country was experiencing so much unrest: COVID-19, the Black Lives Matter protests again police brutality, the reaction to the 2020 election results, and of course what would then be the overturning of Roe v Wade 2 years later which happened as a result of Trump’s ability to elect 3 extreme conservative Supreme Court judges during his first term in office. What kinds of messages do you hope to share through your powerful images, that maybe even allow viewers to feel a sense of hope despite the bleak socio-political reality?
Hope is essential, but in many ways, these projects were fueled by anger—anger at what is being taken away from us, at how we are cared for (or not cared for) in our most vulnerable moments, and at the way pregnant-capable bodies are treated in this country. There is rage in these images—rage at the systemic failures, the erosion of reproductive rights, and the lack of support for those on the frontlines of care.
But there is also love. ‘Extreme Pain, Extreme Joy’ and ‘A Safe Haven for Late Abortions’ are, at their core, love stories set against a backdrop of grief and resistance. They are about the midwives and clinicians who show up every day despite the lack of institutional support, about the tenderness and strength in these spaces, about the radical act of providing care when the system is failing. Through these images, I hope to highlight both the urgency of what we are fighting for and the resilience of those who refuse to stop caring, even in the face of relentless political and social upheaval.
The inclusion of a number of Black women in your series is also very significant, given the racial disparities when it comes to birthing outcomes and maternal mortality in this country. Can you share a little more about what you hope the images of Black women will speak to?
Giving birth in the United States is already a vulnerable experience, but for Black women, the stakes are even higher. The racial disparities in maternal healthcare—higher mortality rates, systemic neglect, and medical racism—make pregnancy and childbirth particularly dangerous. I wanted ‘Extreme Pain, Extreme Joy’ to reflect a range of experiences and perspectives, not only to highlight these injustices but also to uplift and center the strength, resilience, and agency of Black women in birth spaces.
By including Black women in this series, I hope to challenge the dominant narratives around birth in America and draw attention to the urgent need for better care and systemic change. These images are about visibility, dignity, and honoring the people whose stories are too often overlooked. Ultimately, this project is about all pregnant-capable bodies, but it was especially important to me to ensure that Black women’s experiences—both the struggles and the joys—were seen and acknowledged.
What does ‘Extreme Joy, Extreme Pain’ mean to you today in 2025?
Entering 2025, I feel a deep heaviness knowing that my daughter might grow up with fewer rights than I had when I was born. The weight of that reality is overwhelming at times—watching reproductive freedoms continue to erode and knowing that so many people are being denied the autonomy and care they deserve. But alongside that heaviness, there is also determination.
This fight is exhausting, but it’s necessary. What keeps me going are the stories from people who have connected with this project—those who have felt seen, validated, and empowered by these images. ‘Extreme Pain, Extreme Joy’ is more than just a documentation of birth; it’s a reflection of resilience, of care, of the ways people continue to show up for one another despite political and systemic failures. Change doesn’t happen overnight, but moving the line—even just a little—feels worth it.
MOTHER TONGUE MAGAZINE FOUNDERS, MELISSA GOLDSTEIN AND NATALIA RACHLIN
When did you first come across Maggie Shannon’s ‘Extreme Pain, but also Extreme Joy’ photo series, and what drew you to her images?
We first saw them when they debuted in 2020 in the New York Times, which was well before Mother Tongue was even a thing (our first issue launched in August 2021). Our current Creative Director, Vanessa Saba, who came on board after our debut issue, brought the series back to our attention once we started working together, and we ended up publishing an exclusive edit in our second issue, in the spring of 2022.
What was the creative process of turning this powerful series into a book, and working in partnership with her to release ‘Extreme Pain, Extreme Joy’?
In the time since Maggie first published the series she became a friend and recurring contributor to the magazine, and in our conversations with her we all felt the meaning of the series continued to evolve in relation to the conversation around reproductive justice. When Maggie decided she was interested in making a book, we all wanted to present the work in a new light to showcase its relevancy and timelessness.
Our wonderful creative director Vanessa Saba spent time with Maggie creating an original edit of the images and sifting through the wider series to find pairs that really felt like compelling juxtapositions. In addition to including many previously unpublished images, we focused the gaze more on the mother, and the care relationship at the heart of birth.
Mother Tongue magazine has been a fierce champion of bodily autonomy and reproductive freedom since its inception. What does it mean to you both to be a platform for these issues as we head into 2025, and in the wake of so many horrific stories of women dying from abortion bans since Roe was overturned?
It is a privilege to have this platform, and sometimes daunting, to make the most of using it as a positive force for change in our own small way. We have always thought of storytelling as a kind of activism, sometimes it’s quiet, sometimes it’s loud, and sometimes it’s not even entirely obvious: but to seed ideas, or to challenge perspectives in subtle and meaningful ways, is something we are so compelled by.
We feel like these stories that center women’s experiences are more crucial than ever: and we will probably have to be louder in order to break through the media shitstorm that will come later this month with the change of administrations. To be a counter-narrative to the misogyny that’s going to be spewed across the mainstream media, to continue to empower women’s voices and be a platform for diverse points of view and challenging conversations, is our jam.
What do you hope viewers will love most about this book, and what kind of messages do you hope it will spread?
The book has received some lovely press, and perhaps the writer Malene Engelund put it best, in her review in Dazed:
“’Extreme Pain Extreme Joy’ is a rallying cry for women: for the women at the centre of the lens, and for the community which circles them and provides the structure and support that upholds women’s rights. The photographs, as well as the creation of the book itself, insist on the impact and transgressive act of procreation—physically or artistically—in the face of profound change.”
The images we see are very intimate, capturing both a vulnerable moment but also very powerful and primal. Why do you think it is important for more people to see these kinds of images, as opposed to what we are used to seeing in movies and TV?
Birth is foundational, quite literally, for every human on this planet. We are so tired of hearing that birth is “niche.” It is arguably the one shared human experience, it’s time to talk about it, make it safer, and celebrate it for the powerful, awesome event that it is.
What is the importance of uplifting the work of midwives in this series, especially at a time when the future of maternal and reproductive medical care is uncertain in many states with abortion bans, where OBGYNs are are leaving behind maternal care deserts?
Maggie can inevitably speak to this so much better than we can, but from our perspective, it is about highlighting all the options that women have, and making sure they have the freedom to make choices that work for them. In the foreword, the brilliant Angela Garbes talks about safety and what that word means in this specific context: Maggie places such emphasis on making her subjects feel safe while she is there, and all we can do is wish that women feel safe and are safe, in whatever context they choose to receive care.
If you could both describe or sum up what ‘Extreme Pain, Extreme Joy’ means to you, what would you say?
Epic, life-affirming, important: Maggie’s work highlights discussions that need to be at the forefront at this moment when reproductive justice is more threatened than ever. Motherhood and childbirth have become highly politicized issues in America—it’s frightening but also an opportunity to make sure that we collectively band together to protect women’s autonomy, and continue fighting for the rights that unfortunately are still not guaranteed. This book is ultimately a celebration of women’s power, and the power of community, and what we are capable of when we come together: a message for our times for sure.
Buy a copy of ‘Extreme Pain, Extreme Joy’ HERE, get familiar with the work of Mother Tongue magazine, and follow them on Instagram. See more of Maggie Shannon’s work on her website, and follow her on Instagram.
