Many changes have buffeted society over the past several years: the increasing popularity of joint custody as a way for divorced parents to provide for their children; the rising number of wives and mothers in the work force; the apparent decline of reading and writing skills among the young; the increasing number of middle aged people continuing their formal education; the increasing number of unmarried couples living together; the rising number of divorces. The ways of managing childbirth in traditional societies are many and varied; their usefulness stems directly from the fact that they are accepted culturally and collectively so that the mother does not have the psychic burden of reinventing the procedures. Even though the potential catastrophes are alive in the memory of her community and the index of anxiety high, a ritual approach to pregnancy which hems the pregnant women about with taboos and prohibitions helps to make the anxiety manageable. This birth was virtually unattended. In non-technocratic societies, except for remarkable accidents, birth is always attended. Clearly infant and mother mortality is greater in traditional births, but in our anxiety to avoid death we may have destroyed the significance of the experience for the vast majority who live. No one would deny that each infant and particularly every maternal death is a tragedy to be prevented if at all possible, nor that modern obstetric care, which has developed in the hospital setting, has been at least partly responsible for the dramatic decrease in both maternal and perinatal mortality over the past half century. The voice of a few women raised in warning cannot be heard over the humming and throbbing of our machines, which is probably just as well, for if we succeed in crushing all pride and dignity out of child bearing, the population explosion will take care of itself.
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