AUTHORITATIVE KNOWLEDGE AND ITS CONSTRUCTION

Introductory Remarks to Symposium on "Birth in Twelve Cultures:

Papers in Honor of Brigitte Jordan"

Annual Meetings of the American Anthropological Association,

San Francisco CA, December 3, 1992

Brigitte Jordan

Xerox Palo Alto Research Center and

Institute for Research on Learning

Last Changes: 92.12.01

Abstract: Authoritative Knowledge and its Construction: Within any particular social situation a multitude of ways of
knowing exist, but some carry more weight than others. Some kinds of knowledge are discredited and devalued, while
others become socially sanctioned, even o3cial, and are accepted as grounds for legitimate inference and action. In the
hope of contributing to the design of better social and technological support for people's activities during childbirth and
otherwise, I explore the characteristics of settings, social arrangements, and technologies that lead to particular
distributions of authoritative knowledge and attendant decision-making power. (10 mins.)

I cannot begin to express to you how deeply I feel the honor you have accorded me
with this symposium. I am tremendously pleased to 8nd assembled in one spot such
a large number of individuals who are all actively involved in the anthropological (in
contrast to the medical) study of birth. When I began investigating childbirth and
midwifery in Yucatan (and I believe that is now almost exactly 20 years ago), what
we now know as the Anthropology of Birth or the 8eld of Ethno-Obstetrics did not
exist.

There were a very few anthropologists who had ever even considered the topic in
any systematic way (there was a seminal survey article by Margaret Mead and Niles
Newton which mostly bemoaned the fact that there were no good ethnographic data
on childbirth and some crosscultural comparisons pulled out of the Human Relations
Area Files). But there were few anthropologists who considered the topic a legitimate
topic in anthropology -- and even that is saying too much. It wasn't that people
argued is it or isn't it legitimate, it simply wasn't there. Childbirth did not exist in
anthropology.

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There was no notion of birth as a cultural system; the idea of ethno-obstetrics (a
term later coined by Carol McClain) had not seen the light of day, nor the notion that
western cosmopolitan obstetrics could be studied in a comparative anthropological
manner as just another ethno-obstetric system (an idea that Robert Hahn has been
responsible for). Believe me, for a struggling graduate student those were
intellectually lonely days indeed.

So I am tremendously pleased to see how far we have come. The Anthropology of

Birth is now a lively and vital 8eld and if I have contributed to its growth, I take great
pleasure in that.

[I also take great pleasure in the republication of Birth in Four Cultures which truly
would not have happened without the labor of love bestowed on it by Robbie Davis-
Floyd. The book has been updated and revised. We also added three new chapters
to it which contain some of my more recent writings. ... none of which would have
happened without Robbie's dedication.]

Now, I think I should also tell you that I no longer work in the area of childbirth. I've
changed my career, again, (I actually think it takes about ten years to make a dent
in a given 8eld), and after having participated in illuminating, at least partially, the
territory of childbirth, I felt I needed to move on. In my current life I am trying to
understand, together with my colleagues at Xerox PARC and IRL, how people
organize themselves to work together, play together, live together -- and what we as
anthropologists and social scientists can do to contribute to the design of better
working and learning environments.

So I have been less directly concerned with childbirth recently and have focused
more on the underlying, or I am tempted to say, overlying question of cultural
change, and in particular the role new kinds of artifacts and technologies play in that
change. But while the shift from medical anthropology to the anthropology of work
may seem fairly radical, there are also some underlying themes that have remained
constant, and that actually have deepened in signi8cance for me in my exposure to
industrial work settings. One of these is the notion of authoritative knowledge.

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There are two ways in which one might use the idea of authoritative knowledge:

• one, the more conventional use, sees authoritative knowledge simply as the
knowledge that is attached to persons in authority positions, as, for example, the
doctor in childbirth, the teacher in the classroom, the foreman in a plant;

• the second, and this is what I have been mostly concerned with, looks at AK
as the knowledge on the basis of which decisions are made in a given setting, by a
given social group.

Let me tell you what I think the second use buys us.

One issue that arose for me very early on in my work came from the observation
that in some social situations multiple kinds of knowledge are present by virtue of
the experience and background of the various participants. In some groups, these
diEerent kinds of knowledge are in conFict, in others, they become a resource for
constructing a joint way of seeing the world, a way of de8ning what shall count as
authoritative knowledge.

This is the case, for example, in childbirth in Yucatan where women in the rural
communities draw on a large body of wisdom that is assembled in each particular
birth from a shared history and from the experience of those present, that is, the
woman's immediate family, the village midwife, and other experienced women in
the community. What is interesting is that in such situations, all participants lend a
hand to give aid -- physical, emotional, ritual, spiritual -- and if the labor is drawn-out
and di3cult, they build a shared store of knowledge through stories,
demonstrations, and remedies. In this manner, a joint view of what is going on in
this labor, with this woman-plus-baby, is constructed in which everybody involved in
the birth shares.

In contrast to western medicalized births, there is no one in charge here. There is no

single decision-maker. It is certainly not the midwife (which was initially a surprise
for me because I expected her to act as some sort of doctor equivalent); it is not the
woman, either (which was something that I, as a feminist graduate student, would

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have loved to see). Rather, the store of knowledge required for conducting a birth is
created and recreated by all participants jointly as they do the work of birthing.

What is interesting is that we have also found this horizontal distribution of

authoritative knowledge in our more recent work in high-technology work places. For
example, when we studied the control center for an airline's ground operations, we
found that the people who work there are also constantly engaged in updating each
other on the state of their world, where the "world" at issue is the world of planes in
the air, on the ground, and at the gates and their state of readiness in regard to
passengers, baggage, fuel, food and crews. In this situation information coming into
the room through any of a number of channels (such as printers, radios, telephones,
computer screens, video monitors) is potentially relevant to everybody in the room
and we 8nd that information is not treated as privileged. People do not withhold
information, they constantly give and solicit help, and they develop shared work
practices and technologies which support the joint updating of the common stock of
knowledge on the basis of which decisions are made in the room.

To be sure there are supervisors in the ops room. But for the routine work of getting
planes in and out they function not so much as controllers of information and
decision-makers but as an extra pair of hands, an extra set of vigilant eyes,
somebody who can keep watch over a particular problem as it develops and possibly
link to outside resources if they are required. The routine decisions are all made by
the working team.

In contrast to the ops room, there are other situations where multiple kinds of
knowledge donot come together, where one kind of knowledge wins out and carries
the day. This is typical for American hospital births where medical knowledge
supersedes and delegitimizes other potentially relevant sources of knowledge such
as the woman's prior experience and the knowledge she has of the state of her body.
Nonmedical knowledge is devalued by all participants, usually including the woman
herself who comes to believe that the course charted on the basis of professional
medical knowledge is the best for her. If she does not acquiesce and decides to
actively resists, we get, in the extreme case, the phenomenon of court-ordered
cesarean sections, that is, the legal enforcement of one particular kind of
knowledge.

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I've surely painted a one-sided picture here and things are by no means as black
and white and as uncomplicated and straightforward as I have made them out for
the sake of a 10-minute presentation..

Maybe the question we might want to ask at this point, is: does this kind of analysis,
i.e. an analysis in terms of Authoritative Knowledge, give us any leverage for
restructuring the shape of birth in our own society. And I think it does. I think what
we need to think about is how we can move from a situation in which authoritative
knowledge is hierarchically distributed, into a situation where it is, by consensus,
horizontally distributed, i.e. where all participants in the labor and birth contribute to
the store of knowledge on the basis of which decisions are made.

In our technocratized systems we need to ask questions such as: What would have
to happen for the woman to truly become a part of the decision-making process?
What if her knowledge, both bodily and intellectual, were to be accorded legitimate
status? What if she had a place in the professional participation structures set up
around the birth? Could there be a translation process between what the woman
knows and what the staE understand to be the situation? Could there be a mutual
accommodation of these divergent ways of knowing such that one single
authoritative knowledge structure emerges?

This, I believe is the challenge for the future of childbirth in the technologized
western world as well as in the developing countries of the Third World.

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