Brigette Jordan cites three reasons why a cross-cultural analysis of childbirth practices is important. First, childbirth is something that happens in every single culture, so it is one of the few areas in which such a large range of human variability can be studied and documented. Second, childbirth is generally a women’s business, so its study helps us learn about female social networks, which were previously largely ignored in anthropological studies. Finally, a cross-cultural comparison of childbirth practices allows us to understand the overall process of childbirth better than we could by studying it from inside any one cultural framework. (Jordan, 5-6) Some questions we can ask about childbirth practices in different cultures have to do with who is present at a birth, what physical position laboring women are in, and what types of intervention are appropriate for an attendant to use if there are problems with the delivery. By answering these questions for three different cultures, we will begin to see how much variation there is in human responses to the natural event of childbirth, and how, if at all, female social interaction affects and is affected by the process of childbirth. We will also see some of the characteristics that seem to be common to most cultural variations of childbirth practices, and which aspects are particular to only a subset of human societies.

Perhaps the most obviously varying aspect of the process of childbirth is who is allowed or expected to be present at the delivery itself. Among the Mayans of Mexico’s Yucatán peninsula, a laboring woman’s husband is expected to be present, and there have even been cases “where the husband’s absence was blamed for the stillbirth of a child.” (Jordan, 33) The woman’s mother should also be there, and for their first births, many women deliver in their mothers’ homes. When labor is long and difficult, many other women will show up, including mothers-in-law, godmothers, sisters and sisters-in-law, and even close friends and neighbors. In order to attend a birth, each of these women must already have given birth themselves. In addition to them, a traditional midwife, who is typically a well-respected member of the community, is present to help with labor and delivery. In some contrast to this, women in a Turkish village would be shocked to see a laboring woman’s husband in the room when she gives birth. “It is shameful for any man, including the husband, to see a woman’s genitals.” (Delaney, 129) Rather than giving birth in her mother’s house, or in her own house with her mother and many other women present, a Turkish woman is likely to give birth in her mother-in-law’s house with only her mother-in-law and a traditional or government midwife present. Unlike in both Yucatán and Anatolia, the majority of women in the United States give birth in hospitals rather than at home. As a result, the people expected to be present for a birth include medical personnel who would only be near a laboring woman in either of the other locations if something had gone wrong with the delivery. In addition to the pregnant woman’s husband and a medically trained obstetrician, an American hospital birth may see the presence of one or more nurses, nursing students, and medical students. If it is decided that an emergency caesarian is necessary, several more people, including an anesthesiologist, will also be present.

Though it may seem like something that would have less cross-cultural variation than who is allowed to witness a birth, the position women assume to deliver can differ as much between cultures as anything else. In a hospital in the United States, women typically give birth in what is known as the lithotomy position. In this position, the woman is laying down, usually on a bed, with her feet held up and separated in metal stirrups, keeping them out of the way of the doctor working between her legs. The baby is pushed out by the force of the woman’s contractions, as well as possibly pulled by the doctor. In a Turkish village, on the other hand, women at home often give birth sitting on a low stool placed inside of a “large, low, round laundry washtub made of tinned copper or, these days, more likely, of plastic.” (Delaney, 129) In this position, the pushing woman can push against or grab the washtub for support during her contractions, and her sitting position allows the force of gravity to aid in delivery somewhat. When a contraction occurs, her mother-in-law may support the pregnant woman’s back while the midwife kneels in front to watch for the crowning of the baby. In Yucatán, women are expected to find their own styles for giving birth, and the midwife will then help with whatever style the woman chooses. Two common positions have the delivering woman either sitting on a sideways-turned chair or on a hammock. In either case, the midwife sits or squats in front to help and catch the baby once it emerges, while the woman’s husband or another attendant sits behind her, supporting her back and offering his or her neck for the woman’s hands to clasp around.

Compared to who is present and the preferred position for childbearing, the increasing ubiquity of Western medicalized obstetrics has likely had a much greater effect on the types and level of intervention acceptable for attendants to perform if there is trouble with a delivery. Most societies may have developed their own traditional ways of dealing with malpositioned fetuses and the problem of openings too small for the baby’s head to pass through, but today both of these situations often warrant a hospital trip in Turkey. There a traditional midwife will try to move the baby into a good position on the outside, but “never go[es] inside to manipulate the baby. Nor [does she] ever ‘cut’ to enlarge the opening as they do in the hospital.” (Delaney, 130) If the baby cannot be repositioned properly from the outside, the woman is left to hope that there is a way for her to get to a hospital before any irreparable damage is done. In Yucatán as well, midwives are skilled at externally moving the baby into the proper head-down position if her abdominal massage indicates that the baby is in some other position. But the Yucatecan midwife Brigette Jordan and Nancy Fuller got to know during their fieldwork “does not do vaginal examinations and believes that the midwife’s hands should stay out of the birth canal.” (Jordan, 28) She also told Jordan and Fuller that, if tearing of the perineum did occur, she would call a doctor. Given that in both Yucatán and Turkey women may receive Cesarean sections in a hospital when the baby isn’t in the right position, despite their strong aversion to the procedure under normal circumstances, it is not surprising that in American hospital births, “the standard management procedure for breech and other malpresentations is Cesarean section.” (Id.) Also, though it has become less common over the past few decades, performing an episiotomy when the birth canal doesn’t seem like it will allow the baby’s head through without tearing remains a not uncommon procedure. Vaginal examinations are not only acceptable but common in the American hospital setting. In one birth, Brigette Jordan describes how a medical student “performs a vaginal examination without asking permission or explaining what she is doing.” (Jordan, 156)

Even from so few examples, it is readily apparent that childbirth practices vary a huge amount across different human cultures. We see, for instance, that while childbirth is primarily a women’s activity, it is only in the Yucatecan example that female social networks actually have a large influence on who is involved with the delivery. In Turkey, who is present depends on the family of the woman’s husband, and in the United States example it depends on who at the hospital has the time and required medical training. At the same time as we take account of the significant differences in whose presence is seen as appropriate during birth, though, we also must be aware of some of the underlying similarities. For instance, in all three cultures, and indeed in “all known societies, including our own, access to births is limited to a restrictively specified group of people.” (Jordan, 4) And among those who are appropriately present during childbirth, there is at least one person who has had a fair amount of experience attending births. Even though all three of the societies discussed above have the birthing woman assume different positions, in each case she are positioned with one helper in front of her to watch for and catch the baby once it’s born, and one at her head to provide her with physical or emotional support. And even though Turkish and Yucatecan midwives themselves don’t perform “emergency” procedures when the baby isn’t in the right position or is too big to be born without injuring the woman, attendants in all three cultures believe it is sometimes necessary to do such procedures in a hospital.

Via a cross-cultural comparison of these few aspects of childbirth practices, we see that childbirth, a universal biological process that occurs in every human society, varies quite significantly in most of its details from one culture to another. Yet at the same time, we see that amidst all the diversity, there are also a few themes that seem common to human childbirth practices in general. The great differences between some details of childbirth, as well as the parallels among other aspects, suggest that what one culture sees as the “right way” to do childbirth may only be “right” within the limited context of that particular culture. This has significant implications for how we understand pregnancy and childbirth and for how we interact with people whose cultural beliefs about these human universals differ from our own. Furthermore, understanding these implications can only come from a concerted effort to understand childbirth cross-culturally, rather than simply studying it within each individual society.

Sources Cited

Delaney, Carol. 2000. “Making Babies in a Turkish Village”, In: A World of Babies: Imagined Childcare Guides for Seven Societies. Cambridge, UK: Cambridge University Press, pp. 117-44.

Jordan, Brigette. 1992. Birth in Four Cultures. Prospect Heights, IL: Waveland Press.