Book review concepts and methodologies

Wives and Midwives: Childbirth and Nutrition in Rural Malaysia

By Carol Laderman, 1983

Anthropology, according to Merriam-Webster Online dictionary, is "the science of human beings..." In particular, "the study of human beings in relation to distribution, origin, classification, and relationship of races, physical character, environmental and social relations, and culture..."

In reading and analyzing the assigned book by author Carol Laderman, it is important to realize that in terms of her credentials, she is far more than just an author, or a journalist, writing about interesting cultural subjects. To wit, she is the former chair of the Anthropology Department - and currently the co-director of the M.A. Program in Applied and Urban Anthropology - of City College of New York; she has served as a professor at Yale and Fordham Universities; she has received fellowships from the Guggenheim and Rockefeller foundations; she has lectured on her specialty, medical anthropology, nutrition, reproduction, and the sex roles of indigenous cultures in Asia, in India, Japan, England, Canada, Australia, Norway and Finland. (This information was retrieved from the City College of New York Web site.)

Summary of Book - Wives and Midwives: Childbirth and Nutrition in Rural Malaysia

Medical anthropology, which combines the disciplines of physical anthropology, ethnography, linguistics and archeology, presents a "picture of the human condition in the round," author Laderman writes in her Introduction. And medical anthropology can also be employed to try to understand "the workings of a culture," she adds. Indeed, the way a culture works in one part of the world sheds light and understanding on how cultures work in all corners of the world, which is the principal reason for anthropological study.

As for the purpose behind her studies and her book, Laderman writes (7) that she intended to focus on the diet (nutrition) of women following childbirth, but to be thorough, she needed to know if "the diet during pregnancy varied from the non-pregnant diet," in order to understand the changes that take place "during the puerperium" (the time between when a woman gives birth and when her uterus returns to its normal size).

Overall, some of the important anthropological issues Laderman approaches in this book are: 1) "cultural adaptation" - how cultural traits and the "successful interaction" between a people and their environment provide information for anthropologists; 2) the "relationship between belief and behavior" in a culture being studied; in other words, how are people's standards and "ideologies" somehow "manipulated" to achieve "valued ends"; 3) Laderman studied childbirth and nutrition in Malaysia in order to also understand how humans are effected in their reproductive and daily living dynamics by their environment.

The author describes the environment of the Merchang culture of Malaysia (Muslim in faith) in the state of Trengganu (10): a tropical climate with temperatures averaging around 85 degrees most days; lots of water (seashore, river, swamp offer plenty of fishing); "both sandy and rich soil" and "primary and secondary forest" and houses built on stilts "two to seven feet from the ground." Why so high above the ground? To prevent flooding during the monsoon, and to "permit the circulation of air during hot weather" plus it gives children a place to play, and chickens a place to scurry about waiting for morsels of food to drop from the house.

Laderman takes great pains to fully describe the kinds of fish, vegetables and other foods eaten by the Merchang, and the "important rites of passage - circumcision and childbirth - that involve both ritual and food avoidances" (66). There is a constant connection in her book as to why the Merchang people eat and avoid certain foods, and why their beliefs - sometimes supernatural, and magic-based beliefs - guide their daily living patterns.

Pregnancy is a time when Merchang women act on some of their superstitions, such as throwing away the vitamins given them by the Malaysian government's midwife clinic; "their bitter taste may be an indication of their 'heat' (not literal heat, but that it affects the body with a bitter taste) and their potency may cause the baby to grow so large that he tears the birth canal" on his way out (90).

Another subject in which Landerman goes into deep detail is midwifery, the training of midwives, and their importance to the culture. She also of course spends a great deal of time and focus on the time leading up to childbirth, childbirth itself, the role of the shaman ("bomoh"), and the post-partum period.

Main Points of the Author - What she is trying to say

The author goes to great lengths to describe the culture she is researching, so the reader can get a good idea why the results of her studies turn out the way they do, and reveal what they reveal. What she is really saying is that it is important for educated people to gain an understanding of how environment and the food a particular culture eats affects the quality of that culture's ability to multiply and be fruitful. Because once anthropologists understand what aspects of the world around a culture have positive and negative affects on that culture, those lessons can be applied in myriad of other instances. FOCUS ON WOMEN: A woman's part in the culture the author studied is of course pivotal to understanding the childbirth and nutrition issues which are also being carefully documented.

Besides bringing babies into the world, feeding them and in all ways caring for them, Malay women in Merchang appear to be burdened with an enormous amount of manual labor-type duties (11). Women tend to wood-burning stoves, scrub dishes with sand and cold water, draw, boil and store well water (in bottles), scrub floors, burn garbage, cook meals and "fuss over" their husbands when they return home from their daily migratory labor tasks.

And as if this isn't enough work, women spend "part of the day cultivating the fields and/or tapping rubber." And like women in Western society, they don't make as much as men (a typical day's pay for men is M$5.00 while a woman receives M$3.50 for the same work). Women are such a huge part of keeping the family going that "many girls are kept at home after finishing six years of elementary school rather than being allowed to join their brothers in junior high."

MARRIGE, CHILDBIRTH AND SEXUAL VALUES: Indeed, "three-fourths" of the girls in this culture are married by age 16, and "pregnancy soon follows." As to social-sexual values, "even the appearance of illicit sex is a criminal offence" (15), and when an unmarried Muslim couple are caught in a "secluded place" (the crime is known as khalwat, "close proximity"), they are fined severely, serve jail sentences, and their names appear in the newspaper. That said, men are allowed to take two - or more - wives (19): "a bomoh ("magical-medical practitioner") proudly told me that he never committed the serious sin of sleeping with women to whom he was not married." If the man wanted another woman, and was bored with his first, "he married" the new woman, rather than break the social rules on illicit sex.

It is interesting to note that if a woman (who is in labor) has broken cultural and community rules regarding what her role is during pregnancy, or has disobeyed her husband - or "attempted to dominate" him - "she may find it hard to deliver her baby" (151). If the woman has even given thought to being unfaithful, she may not have a safe delivery. And to rectify the situation for her (in the event of any of the above-mentioned rule-breaking), while she is in labor, and "to restore harmony and order in the universe," the midwife tells her husband "to step over his wife's supine body three times." This act, according to the author, "graphically illustrates which sex must be on top and which must be in danger of being trodden underfoot," in a symbolic gesture to be sure that the baby is born successfully.

More than that, if the woman in labor has touched a man in an intimate way - or even "thought of another man carnally - besides her husband during her pregnancy, she might be required to drink water from a cup into which her husband has "dipped his penis." This ritual will "reestablish" her husband's "dominance" over her, and may make delivery go more smoothly. (How anyone other than the pregnant women would know if she indeed had carnal thoughts about a man outside her marriage is not explained by Laderman.)

FOOD AND NUTRITION: The environment provides wild foods such as bundles of greens, wild vegetables (23), tree leaves, mushrooms, species of fern, and eggplants, among others. Fruits are also available in the wild, along with chestnuts. Meantime, notwithstanding the available natural foods, most of the vegetables eaten by the Malay are cultivated in gardens. But on page 21, Laderman writes that while rice fish are plentiful, there is malnutrition in rural Malaysia.

Reaction to the Author's Main Points - are they logical and/or credible?

Laderman is very thorough - and yet very down-to-earth and easy to understand - in her explanations of various issues surrounding the Malay culture, perhaps because she realizes that lay people and students will be reading this book, not just "experts" in anthropology.

In her discussion of why malnutrition should exist in a land of lush vegetation and "eternal summer," where "tropical fruits grow in profusion and every padi field abounds with fish" (21), the reader learns that the Merchang people live by certain "mistaken dietary conceptions." Those misconceptions are based on taboos, and of course, they are also based on ignorance of real human nutritional needs.

As for vegetables, "they are simply additives that improve the taste of rice," and fruits are (21) "just pleasant things to keep the mouth busy." And so, for the Merchang, rice and fish are the only worthy parts of the daily diet. Having pointed that point out, Laderman's initial dietary information becomes credible in terms of the relevance of her research when on page 30, she points out that the typical Merchang meal consists of 40 to 230 grams of vegetables per meal; this is comparable to an American adult's average intake of beans per day: 69.4 grams.

Another believable comparison between American food habits and those of the Merchang in Malaysia (30) reflects that in Ohio farm families, roughly 37% of the children and 34% of the adults eat at least "one green or yellow vegetable daily." Meantime, though the Merchang people think vegetables are just something to enhance the flavor of rice, 63.5% of all households ate a green or yellow vegetable once daily, and 35% ate a green or yellow vegetable twice a day. So, what makes this material logical is the fact that even though the Merchang downgrade the real value of vegetables, they nonetheless eat vegetables in large quantities.

The way in which the Merchang categorize foods, as "hot" (spicy or bitter) and "cold" (more bland), makes perfect sense to the lay person. And the way in which the author explains that Merchang balance "hot" and "cold" food and drink as a way to find equilibrium for their bodies (35-50), is logical and reasonable, given the environment these people live in and their general lack of social and nutritional sophistication given the "modern" western world. What helps a reader understand the "hot" and "cold" beliefs is the list of "Humors and Illness" on pages 50-51: blood is a "hot" humor, and so a bloody nose (though the blood may feel cool) is a "sign that the hot element has become overheated and boiled over."