The Contemporary Pacific 15.2 (2003) 499-502
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Birthing in the Pacific: Beyond Tradition and Modernity? edited by Vicki Lukere and Margaret Jolly. Honolulu: University of Hawai'i Press, 2002. ISBN 0-8248-2408-3; xi + 249 pages, tables, maps, figures, photographs, notes, bibliography, index. Paper, US$19.95.
This book is a treasure. Nuggets of insight and challenge abound throughout, as the authors reevaluate past work with respect to childbearing, offer a sustained critique of the received wisdom from many disciplinary perspectives, and point the way to future exploration of women's lives and confinement. In every chapter, some gems are clearly visible, the author's stance and acumen making them shine and sparkle, while other jewels still lie buried in the text, awaiting an astute and careful reader to mine, cut, and polish them.
Birthing is a critical site for understanding the intersection of medical/social/cultural aspects of life (to the extent that these can be viewed as separate domains of inquiry, even heuristically). In her introduction to this volume, Jolly positions birthing as another intersection, as "a fundamental process of all human life, . . . a subject of academic research, and . . . a central concern of health policy deliberation and action" (1). Lukere, in her conclusion, points to other aspects of this intersection and its wide relevance: "Childbirth is a process personal, collective, physical, symbolic, significant in countless ways. It is also a sometimes precarious deliverer of life and death" (201). The authors—four anthropologists, a community health worker, and a historian—use their particular disciplinary and advocacy backgrounds to address simultaneously (in Scheper-Hughes' phrase) the "poetics and pragmatics" of these intersections. The result is a rich, complex, and provocative volume that puts epidemiology, biomedicine, and social policy into cultural-phenomenological contexts.
Jolly's theoretical overview demolishes several persistent binaries that so plague much of the general literature on birthing, and debates the deeply entrenched notion of "development" underlying most maternal and child health endeavors. Central binaries discussed are "traditional-modern," "natural-technological," "indigenous-colonial," "passive-active." Each of the six data-based chapters fleshes out in multiple ways the limitations of binary positions and offers [End Page 499] suggestions for further investigation of birthing as a site of cultural significance, disciplinary regime, acceptance and contestation, and technocratic change.
Divergence in the interpretations and practices of ma'uli (village-based birth attendants in Tonga) and hospital-based nurse-midwives is the focus of Morton's chapter. Particularly valuable is her discussion of attempts by the state to control reproductive beliefs and practices, and the ironies inherent in a discourse that lauds as the best site for births a medicalized hospital system without sufficient or necessary resources. Fiti-Sinclair addresses the same broad issues, again by contrasting the experiences of and consequences for women who give birth in a village setting versus in Port Moresby's General Hospital. In juxtaposing the views of the women in labor in the hospital with those of the nurses attending them, Fiti-Sinclair shows how and where they develop similar and different assessments of technocratic intervention.
For Kanak women in New Caledonia, Salomon argues, childbirth had been "an exclusively female domain" (96). The introduction of western medicine, however, subordinated women, reducing their access to and use of reproductive knowledge, both to increase or temporarily restrict fertility; changing reproductive beliefs and practices; and altering gender relationships by insinuating men more and more centrally into the childbirth arena. Lukere examines Fiji's decision in 1908 to train native women as obstetric nurses, partly in response to serious depopulation, partly as a means to eradicate "traditional midwives," and partly because of misgivings about the efficacy of male native medical practitioners, particularly in this traditionally female realm. Along with other authors in this volume, Lukere points to a "fundamental underestimation of the constraints upon women in managing these physical and cultural processes [of reproduction] over which they were paradoxically imagined as all-powerful" (121).
In chapter 5, Mallett details the small triumphs and large difficulties of Moses, a twenty-two-year-old male community health worker...