Mainstream Mexican views of indigenous women center on them as problematic mothers, and development programs have included the goal of helping these women become "good mothers." Economic incentives and conditional cash transfers are the vehicles for achieving this goal. With ethnographic immediacy, Shaping the Motherhood of Indigenous Mexico examines the dynamics among the various players—indigenous mothers, clinicians, and representatives of development programs. The women's voices lead the reader to understand the structures of dependency that paradoxically bind indigenous women within a program that calls for their empowerment.

The cash transfer program is Oportunidades, which enrolls more than a fifth of Mexico's population. It expects mothers to become involved in their children's lives at three nodes—health, nutrition, and education. If women do not comply with the standards of modern motherhood, they are dropped from the program and lose the bi-monthly cash payments. Smith-Oka explores the everyday implementation of the program and its unintended consequences.

The mothers are often berated by clinicians for having too many children (Smith-Oka provides background on the history of eugenics and population control in Mexico) and for other examples of their "backward" ways. An entire chapter focuses on the humor indigenous women use to cope with disrespectful comments. Ironically, this form of resistance allows the women to accept the situation that controls their behavior.