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The World Until Yesterday

Jared Diamond
Allen Lane


 Today, childbirth in Westernized societies usually takes place in a hospi­tal, with the help of trained professionals: physicians, midwives, and nurses. Mortality of infants and mothers associated with childbirth is low. But traditional childbirth was different. Before or in the absence of mod­ern medicine, death of the infant and/or the mother in childbirth was much more common than it is now.

The circumstances of childbirth vary among traditional societies. In the simplest case, very exceptionally, a cultural ideal is for the mother to give birth alone and unassisted. For instance, among the !Kung people of southern African deserts, a woman about to give birth is expected to walk a few hundred yards from the camp and give birth alone. In practice, es­pecially for a first-time !Kung mother, she may be accompanied by other women to help, but with successive births the mother is more likely to achieve that ideal of giving birth alone. However, even if the mother does so, she remains close enough to camp that other women can hear the first cries of the baby and then go join the mother to help in cutting the um­bilical cord, cleaning the baby, and carrying it back to the camp.

The Piraha Indians of Brazil (Plate 11) are another group in which women often give birth unassisted. The commitment of the Piraha to that ideal is illustrated by an experience of linguist Steve Sheldon, related by Daniel Everett: "Steve Sheldon recounted a story once of a woman giving birth alone on a beach. Something went wrong. A breech birth. The woman was in agony. 'Help me, please! The baby will not come,' she cried out. The Pirahas sat passively, some looking tense, some talking normally.'I'm dying! This hurts. The baby will not come!' she screamed. No one answered. It was late afternoon. Steve started toward her. 'No! she doesn't want you. She wants her parents,' he was told, the implication clearly being that he was not to go to her. But her parents were not around and no one else was going to her aid. The evening came and her cries came regularly, but ever more weakly. Finally, they stopped. In the morning Steve learned that she and the baby had died on the beach, unassisted. . . . [This tragic incident] tells us that the Pirahas let a young woman die, alone and with­out help, because of their belief that people must be strong and get through difficulties on their own."

Much more commonly, traditional childbirth takes place with the as­sistance of other women. For example, among the Kaulong people of New Britain, whose men are obsessed with the polluting effects of women dur­ing menstruation and childbirth, a woman about to give birth goes to a shelter in the forest, accompanied by several older women. At the opposite extreme are societies in which birth is virtually a public event. Among the Agta people of the Philippines, a woman gives birth in a house in the camp, and everyone in camp may crowd into the house and shout out instructions to the mother and midwife ("push," "pull," "don't do that")...

 Infanticide—the intentional acknowledged killing of an infant—is illegal in most state societies today. In many traditional societies, however, in­fanticide is acceptable under certain circumstances. While this practice horrifies us, it is difficult to see what else the societies could do under some of the conditions associated with infanticide. One such condition is when an infant is born deformed or weak. Many traditional societies ex­perience lean seasons of marginal food supply, when it becomes difficult for the small number of productive adults to provide food for the larger number of non-producing children and old people. An additional con­suming but non-productive mouth is then a burden that the society can ill afford.

Another circumstance associated with infanticide is a short birth inter­val: i.e., an infant born within only two years of the birth of the mother's previous child that is still nursing and being carried. It is difficult or im­possible for a woman to produce enough milk for a two-year-old and also for a newborn, and to carry not just one but two children while shifting camp. For the same reason, twin births by hunter-gatherer women may result in the killing or neglect of at least one of the twins. Here is an inter­view with an Ache Indian named Kuchingi reported by Kim Hill and A. Magdalena Hurtado: "The one [the sibling] who followed me [in birth order] was killed. It was a short birth spacing. My mother killed him be­cause I was small. 'You won't have enough milk for the older one [i.e., Kuchingi],' she was told. 'You must feed the older one.' Then she killed my brother, the one who was born after me."

Still another factor predisposing towards infanticide at childbirth is if the father is absent or dead, and thus unable to help feed the mother and protect the child. For a single mother, life is hard even today. It was harder in the past, especially in societies in which lack of a father tended to result in a higher probability of a child dying, e.g., because fathers provided most of the calories or protected their children against violence by other men.

Finally, in some traditional societies the ratio of boys to girls increases from birth to adolescence, as a result of female infants dying through pas­sive neglect, or (in exceptional cases) even being intentionally killed by strangling, exposure, or burying alive—because many societies value boys over girls. For example, among the Ache Indians, 14% of boys but 23% of girls have been killed by the age of 10. The absence of either the father or the mother increases by four-fold the chance that an Ache child will be killed by homicide, but the risk is higher for girls than for boys. In modern China and India that widespread valuing of boys over girls results in an excess of infant boys by a new mechanism: pre-natal sex determination permitting the selective abortion of female fetuses.

The !Kung consider it a mother's obligation to evaluate the case for or against infanticide at the time of childbirth. The sociologist Nancy Howell wrote, "The custom that women should or can give birth alone gives the mother the unquestioned right to control infanticide. At the scene of the birth, usually before the baby is named and certainly before bringing the baby back to the village, it is the mother's responsibility to examine the baby carefully for birth defects. If it is deformed, it is the mother's duty to smother it. Many !Kung informants told me that this examination and decision is a regular and necessary part of the process of giving birth. !Kung infanticide is not equivalent to murder in their eyes, since they do not consider birth to be the beginning of life of a zun/wa [a !Kung person]. Life begins with giving a name and the acceptance of the baby as a social person back in the village after the birth. Before that time, infanticide is part of the mother's prerogatives and responsibility, culturally prescribed for birth defects and for one of each set of twins born. There are no pairs of twins surviving in the population. . . ."

However, infanticide is certainly not universal in traditional societies and is less common than infant death due to "benign neglect." (That eu­phemism means that an infant is not actively killed but instead dies through neglect, e.g., due to the mother stopping nursing, or nursing the infant less often, or rarely cleaning or washing the infant.) For example, when Allan Holmberg lived among a group of Siriono Indians in Bolivia, he found that infanticide and abortion were unknown. Even though 15% of Siriono children were born with club feet, and only one out of five of those children survived to adulthood and raised a family, those children received normal love and feeding.....