I first read this ethnography as an undergraduate major in anthropology, and now that I've started to teach college level courses as a graduate student in anthropology, I have assigned it in my classes for the last 2 years. Students are always fascinated with the information found in the book -- (largely because this may be the first time in their entire lives that anyone has given them frank information about birth in the US, let alone in other cultural contexts) -- and fruitful and interesting discussions have taken place in my classes after students have read this ethnography. I would highly recommend it for undergraduate and graduate courses in general anthropology, medical anthropology, ethnography, and a myriad of other anthropology, social science, and medical/biology courses.One thing that I have noticed about those who want to argue about Jordan's findings is that they overemphasize the quoting of statistics from third world nations and that they have a need to justify how Jordan's statistical info about the United States is not as bad as statistical info from other nations -- as if the deaths of a few thousand babies per year here is better than the deaths of many thousands of babies per year elsewhere. This information is often coupled with a need to bring in still other types of birth statistics that are meant to nullify or throw into question the validity of birth statistics that show how the US consistently lags behind other industrialized nations in infant mortality rates -- today as well as in Jordan's "ethnographic present" time in the late 1970's.
But these kinds of arguments just show how much people can and do miss the point of reading this ethnography.
The most pressing, and central, point to Jordan's work is that everywhere people are convinced that their birthing system is superior to the birthing systems of other peoples in other places and that this superiority is always defined according to what the people within a culture believe to be the "natural" definition of birth. In the Yucatan, birth is hard work that women need to accomplish in their homes with their husbands at their sides, so it is inferior to give birth in a strange room in a hospital with few family members in attendance and with strangers violating their bodies with vaginal exams while they labor. In the United States, in contrast, birth is seen as a medical event out of necessity because Americans focus on birth pathology and they want medical professionals in attendance to save them "just in case" anything goes wrong. So, it is inferior to many Americans to labor at home, with non-AMA medical professionals in attendance, and with the awful possibility of something going wrong looming over their labor. This kind of chauvinism is cross-cultural and, unfortunately, it is very much in evidence whenever I see any negative American response (i.e. to quote statistical data on birth pathology, of course!) to Jordan's work.
Birth in Four Cultures is not a statistical treatise on birth nor is it meant to teach people about how to do birth "right." It is an anthropological study of the cultural logic people use to discuss, understand and perform birth. It is a descriptive account of how human cultural variation extends to biological matters. If you're reading it in the hopes of proving how American birth is the best type of birth system on the Earth, then you're reading it for the wrong reasons and you're not learning anything new. If you're reading the book in the hopes of proving how American birth is inferior to other birth systems on the planet, then you likewise are not reading it for the right reasons and you're not learning anything new. As Jordan points out, there are "good" and "bad" points to all of the birth systems she describes.
But, if you're reading Jordan's work to learn about human variation and cross-cultural information on birth, then you're going to be delighted with the ethnography. There is a great deal of ethnographic detail that brings the reader into the different worlds -- Mayan, American, Swedish, Dutch -- where women labor. There are moments of great humor and moments of great poignancy. It is an affective and effective work on many levels -- emotionally, scientifically, academically, socially.
If, after reading all of this, you find that it causes you to question some of the logic behind the birth protocol within your own culture, then accept this. If you're old enought to read the book, then you're old enough to understand that no cultural practice or group of people is without fault and flaw. Instead of trying to fight with, and deny the importance of, what you've learned that you don't like, become a person who individually paves the way for positive birth change according to the definitions within your own culture and using the new information you've gained about cultures not your own.
As Jordan says, all birth systems eventually change. How they will change is a mystery, but that they will change is certain. Be proactive in the kind of birth change that happens in your own culture, in your own life, and in how you demand to be treated -- or loved ones to be treated -- during labor. Most of all, though, become instrumental in making birth change be for the benefit of women and babies. This, and not ammunition for cultural chauvinism, is a message everyone should be able to grasp from Jordan's work.
