Ways of knowing about birth in three cultures.

This article examines the concept of authoritative knowledge elaborated by Brigitte Jordan, using examples of birthing systems in Mexico, Texas, and Jamaica. We explore the linkages between the distribution of knowledge about birth and the use of technology; the valuation of biomedical and alternative "ways of knowing" about birth; the production of authoritative knowledge through interaction; and the relationship between authoritative knowledge and social status. In the Maya low-technology, collaborative birthing system in Mexico, the midwife and other adult women share knowledge about birth. In contrast, Spanish-speaking women undergoing cesarean delivery in a high-technology public hospital in Texas are, due to their limited English, only minimally able to interact with hospital staff. While they acknowledge the authoritative position of biomedical personnel and value technology, they protest their inability to communicate during their hospitalization. Jamaican women deliver in a formerly high-technology hospital system that is now experiencing economic austerity measures that render it increasingly dysfunctional. While use of technology is infrequent in the Jamaican case, authoritative knowledge remains vested in biomedicine. By means of three examples we respond to Jordan's call for a rethinking of authoritative knowledge in high- and low-technology settings.