In the first decade after the collapse of the Soviet Union, deteriorating public health indicators such as below-replacement fertility and high rates of sexually transmitted diseases, abortions, birth traumas, and maternal mortality raised acute anxieties about Russia's future. This study documents the efforts of global and local experts, and ordinary Russian women in St. Petersburg, to explain Russia's maternal health problems and devise reforms to solve them. Examining both official health projects and informal daily practices, Michele Rivkin-Fish draws ethnographic and theoretical insights about the contested processes of interpreting and managing neo-liberal transitions in Russia and explores the challenges of bringing anthropological insights to public health interventions for women's empowerment. Michele Rivkin-Fish is Assistant Professor of Anthropology at the University of Kentucky.