Book excerpt: For many years there has been growing concern about the culture of fear that is penetrating maternity services throughout the world, and that the fear felt by maternity care workers is directly and indirectly being transferred to the women and families they serve. The Roar Behind the Silenceprovides information, inspiration and practical suggestions to support maternity care workers, policy makers, and maternity care funders across the world in their quest to deliver sensitive, compassionate and high quality maternity services."