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When it comes to pregnancy and childbirth, says Chavi Eve Karkowsky, “everything is almost always okay.” But as a maternal fetal medicine specialist, she goes on, “I live in the almost.”

In “High Risk: A Doctor’s Notes on Pregnancy, Birth and the Unexpected,” Karkowsky writes about the wrenching losses and hard-won victories she’s witnessed in her work. Karkowsky, who trained in Boston and now practices in New York, wasn’t always sure what specialty she’d pursue. “When I was in medical school I kind of didn’t know what I wanted to do with my life. I thought I was going to be a pediatrician or a child psychiatrist,” she said. “It turned out I loved adrenaline and procedures. I thought that learning how to fix something on a human body was this amazing opportunity. Nobody was more surprised than me.”

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Writing about the medicine she practices is important to Karkowsky, in part to help share stories that often go untold. “We’re not as clear as we should be in terms of what we ask of women when we talk about pregnancy. We gloss over the demands,” she said. “The thing I hear the most is ‘I wish someone had told me.’”

More than just open discussion about the difficulties and joys of women’s reproductive lives, we need informed public policy. After all, when you find yourself pregnant, “you want to make sure you have a fully stocked hospital, and really well-trained physicians, and money going into research. And all of these are decisions that are made for the long term, not the short term. These are not things we want to be playing catch-up with. The cost of not being prepared is much too high.”

Chavi Eve Karkowsky will read at 7 p.m. March 17 at Brookline Booksmith.


Kate Tuttle, a freelance writer and critic, can be reached at kate.tuttle@gmail.com.