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Social Processes and Fertility Change: Anthropological Perspectives

ANTHONY T.CARTER

At the core of recent studies of social processes and fertility change is the proposition that fertility declines are the result, in whole or in part, of the diffusion of new knowledge and ideas “from one locale, social group, or individual to another” (Retherford and Palmore, 1983:296; see also Cleland and Wilson, 1987, Rosero-Bixby and Casterline, 1993; Montgomery and Casterline, 1993). From the perspective of contemporary anthropology, this work has several salient features. Diffusion is thought to be at work in producing a fertility decline when two criteria are met. First, knowledge of parity-dependent birth control and ideas sanctioning its use must, in fact, be new. Second, their spread in space and time must match diagnostic patterns; “birth control and resulting marital fertility decline” spread to all parts of “culturally homogeneous populations” very rapidly (Cleland and Wilson, 1987:24), “date is a better predictor of the onset of decline than socio-economic indicators” (van de Kaa, 1996:421). Implicit in such theories is the assumption that ideas and items of knowledge remain unchanged as they spread from one population to another and from one person to another within a population. Diffusion, therefore, tends to move a population from one homogeneous state to another.

Accounts of fertility change emphasizing the role of social processes have been constructed against a background of microeconomic models of fertility determinants (e.g., Easterlin, 1978, 1983). Cleland and Wilson

Anthony Carter is professor of anthropology at the University of Rochester.



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Diffusion Processes and Fertility Transition: Selected Perspectives 5 Social Processes and Fertility Change: Anthropological Perspectives ANTHONY T.CARTER At the core of recent studies of social processes and fertility change is the proposition that fertility declines are the result, in whole or in part, of the diffusion of new knowledge and ideas “from one locale, social group, or individual to another” (Retherford and Palmore, 1983:296; see also Cleland and Wilson, 1987, Rosero-Bixby and Casterline, 1993; Montgomery and Casterline, 1993). From the perspective of contemporary anthropology, this work has several salient features. Diffusion is thought to be at work in producing a fertility decline when two criteria are met. First, knowledge of parity-dependent birth control and ideas sanctioning its use must, in fact, be new. Second, their spread in space and time must match diagnostic patterns; “birth control and resulting marital fertility decline” spread to all parts of “culturally homogeneous populations” very rapidly (Cleland and Wilson, 1987:24), “date is a better predictor of the onset of decline than socio-economic indicators” (van de Kaa, 1996:421). Implicit in such theories is the assumption that ideas and items of knowledge remain unchanged as they spread from one population to another and from one person to another within a population. Diffusion, therefore, tends to move a population from one homogeneous state to another. Accounts of fertility change emphasizing the role of social processes have been constructed against a background of microeconomic models of fertility determinants (e.g., Easterlin, 1978, 1983). Cleland and Wilson Anthony Carter is professor of anthropology at the University of Rochester.

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Diffusion Processes and Fertility Transition: Selected Perspectives (1987) see theories of diffusion and of economic demand as mutually exclusive, while Montgomery and Casterline (1996) see them as empirically indistinguishable and mutually reinforcing, but the two approaches always are opposed conceptually.1 Microeconomic theories attend to the choices of representative individuals or couples abstracted from their social settings. Diffusion theories attend to communities in which people interact. Observing, discussing, criticizing, and evaluating, people pass information from one to another and from public sources to groups. Communication along interpersonal channels and through impersonal media provides information about “the existence of new behavioral options,” narrows “the range of uncertainty regarding the consequences of new choices,” and “reduce[s] the costs of innovation” by modifying social norms (Montgomery and Chung, 1999:181). Learning is social as well as individual. Attention to the role of social processes in fertility change has led to renewed interest in community-level effects.2 In microeconomic accounts of fertility change, structural characteristics of communities such as the level of nonagricultural employment, literacy, and accessibility are conceived of as determining the costs and benefits of children and the costs of fertility regulation. In accounts of fertility change based on diffusion, social learning may produce a process of endogenous feedback that causes changes in fertility to outpace changes in socioeconomic determinants. Influenced by one another, the members of a community also may develop distinctive patterns of contraceptive use. The boundaries between communities, whether ethnic, linguistic, or cultural, are seen as impeding the flow of communication, thus setting communities on divergent paths of fertility change. All of this points us toward a socially informed theory of fertility change, but it remains dependent on outdated concepts of culture. Paralleling Hammers (1990:456) “agenda…for a culturally smart microeconomics,”3 this paper sketches an approach to research on diffusion informed by contemporary developments in the theory of culture.4 The first section of the paper briefly reviews the place of diffusion in three moments of twentieth-century anthropology: early studies of the history and geographical distribution of cultural traits, mid-century studies of the structure and function of sociocultural systems, and the more recent turn from structural functionalism to practice. The second section argues that key anthropological studies, largely in the classic structural functional mold, undercut or sharply qualify two key assumptions of theories of diffusion based on imitation or contagion: that knowledge and ideas concerning birth control are likely to be novel and that they remain unchanged as they spread from one culture to another. The third and fourth sections, based on contemporary developments in practice theory, outline

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Diffusion Processes and Fertility Transition: Selected Perspectives an alternative view of the social processes through which diffusion takes place and suggest some elements of a program of ethnographic research. DIFFUSION IN ANTHROPOLOGY: A BRIEF HISTORY Contemporary sociocultural anthropologists are likely to respond to ideas about diffusion with considerable suspicion (e.g., Kreager, 1998). Nevertheless, there is considerable anthropological interest in theories that comprehend human agency as embedded in or spread over culture and social organization. The key to these diverse responses to research on social processes and fertility change is the history of anthropological theory. Diffusion theories played important roles in several anthropological debates in the nineteenth and early twentieth centuries. For a clear and sympathetic account of this work, we may turn to the distinguished American anthropologist, Alfred Kroeber. As Levi-Strauss (1953:533) noted, Kroeber was a “highly structure-minded scholar” who nevertheless devoted “most of his time to distribution studies.” In Kroeber’s (1931:139) words [diffusion is the process, usually but not necessarily gradual, by which elements or systems of culture are spread; by which an invention or a new institution adopted in one place is adopted in neighboring areas and in some cases continues to be adopted in adjacent ones until it may be spread over the whole earth. It was recognized that diffusion takes place from one individual to another, within as well as between cultures. However, the focus of anthropology was “cultures rather than…the persons carrying them, so that attention has been centered on the relations between cultures or between the several parts of one culture” (Kroeber, 1931:140). Kroeber observed that the “psychological basis” of all forms of cultural transmission, diffusion as well as tradition, is imitation.5 Diffusion occurs when persons belonging to different populations and carrying different cultural units are brought into proximity by “migration and colonization, that is, ethnic movements; conquest; missionization; commerce; revolution; and gradual infiltration” (Kroeber, 1931:140). Diffusion produces and may be recognized by patterns of distribution in time and space (Rouse, 1953:71). In the later years of the nineteenth century and the first years of the twentieth, there were two principal schools of anthropological diffusionism. The German-Austrian school was polygenetic, conceiving of the history of human culture in terms of “seven or eight original” culture complexes (Kulturkreise) that originated at different times and places and subsequently spread over the whole world, mixing in different places in

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Diffusion Processes and Fertility Transition: Selected Perspectives varying ways. The rather more colorful English school was monogenetic. What were termed “primitive cultures” were regarded as stagnant. The history of human culture prior to the invention of civilization by the Greeks was held to be a consequence of the fact at one time and place…namely in Egypt around 3000, B.C., an unusual constellation of events produced a cultural spurt leading to the rapid development of agriculture, metallurgy, political organization and kingship, priesthood, concern with the after life and mummification, writing and other cultural institutions. From this center of origination this great cultural complex was carried in whole or in part, with secondary embellishments and degenerations, to Mesopotamia and the Mediterranean world, to India, Oceania, Mexico and Peru and in fragmentary form even to remote peoples who remained otherwise primitive (Kroeber, 1931:141). Elements of the German-Austrian school were introduced into American anthropology by its founding figure, the German immigrant Franz Boas, and his students. Recognizing that the partisans of the German-Austrian and British schools “very early took a long a priori leap” from a “modest empirical beginning” (Kroeber, 1931:142), American anthropologists eschewed historicist cultural archetypes and universal patterns in cultural history. Instead, they used careful historical accounts of the independent invention and diffusion of cultural elements as diagnostic devices to discern the ways in which the different components of a culture are connected. Diffusionist arguments went out of fashion in anthropology between the two world wars. They lost their appeal when anthropology ceased to regard cultures as collections of distinct traits for which historical explanations were appropriate and began to conceive of cultures and societies as systems of mutually defining elements for which functionalist and structuralist explanations were appropriate. Two arguments were decisive. One was Malinowski’s argument from functionalism. On the one hand, Malinowski strenuously objected to the idea that inventions could ever be independent. Beyond calling attention to the fact that particular inventions are made repeatedly by different persons in the same culture and in different cultures, he insisted that they are what would now be called socially distributed achievements. Each invention is arrived at piece-meal, by infinitely many, infinitely small steps, a process in which it is impossible to assign a precise share to any one worker or still less to connect a definite object and a definite idea with a single contribution (Malinowski, 1927:29). On the other hand, Malinowski argued that all cultures are independently driven by the demand to meet the functional requirements of human exis-

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Diffusion Processes and Fertility Transition: Selected Perspectives tence. Because the elements of each culture fit together to meet such requirements as the “biological need for propagation and the cultural need for educating each generation” any custom or artifact borrowed by one culture from another has to be “reinvented” to fit into—to function in—its new setting (Malinowski, 1927:37, 42). The borrowed element thus becomes something new. The result is that diffusion as it was conventionally defined never takes place; it is always a readaptation, a truly creative process, in which external influence is remoulded by inventive genius… Civilization is fortunately not a disease—not always at least—and the immunity of most people to culture is notorious: culture is not contagious! (Malinowski, 1927:46). The notion that a borrowed element became something different in a new environment was driven home by structuralism. First, preeminently, in the linguistics of Saussure (1986) and then in the anthropology of, for example, Radcliffe-Brown (1922), structuralism insisted that the meaning of an element of language or culture inhered not in its isolated essence but rather in its relationships to other elements of the system of linguistic or cultural signs in which it occurred. Together with attacks on “pseudo-history” (e.g., Radcliffe-Brown, 1950:1–2), these arguments resulted in a new emphasis on synchronic explanations. No longer were institutions and customs to be explained in terms of their origins. Rather, as Fortes (1953:25) put it in his inaugural lecture as William Wyse Professor of Social Anthropology at Cambridge, Functional research investigates either the part played by institutions and customs in operating and maintaining the total structure of a society or of a type of society; or conversely, it seeks to analyse the action upon one set of institutions of the other parts of the social system. In the past several decades, the mid-century structural-functionalist consensus has broken up, and not a few anthropologists have turned to one or another version of practice theory.6 Practice theorists reject structural functionalism’s sharp separation of culture and human agency, the former conceived of as a set of rules or meanings and the latter as universal, abstract rationality. From the perspective of practice theory, culture no longer exists outside of and prior to action but instead takes shape as it enters into activity. Conversely, human agency is shaped by and spread over its social contexts. As Hammel put it in his 1990 essay “A Theory of Culture for Demography,” culture is a “negotiated symbolic understanding” or an “evaluative conversation,” a “constantly modified and elaborated system of moral symbols” produced and reproduced by “the evaluative behavior of actors.” These evaluative behaviors or

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Diffusion Processes and Fertility Transition: Selected Perspectives symbolic expressions…become part of culture as guidance mechanism by entering into the social discourse. Actors respond to this discourse; their actions are guided by it, whether it is spoken in their presence, recalled from their socialization, or anticipated for their repute or their salvation. Social action takes place in, is shaped by, and at the same times shapes “an intensely evaluative cloud of commentary” (Hammel, 1990:467). Nor is history secondary to synchronic analysis. The activities of human subjects are shaped by structured contexts that are the products of past human activity. At the same time, human activities, as structured products, become structured contexts that shape future activity. The formation of the populations/societies studied by demographers and anthropologists occurs “at the intersection of global and local histories…local groups… [are seen] as the products of centuries of social, economic, political, and cultural processes, some indigenous, other originating at regional, national, and global levels” (Greenhalgh, 1990:90)7 If structural functionalism decisively refuted theories of diffusion based on imitation or diffusion, these features of practice theory together point to a view of social processes in which a different form of diffusion is ubiquitous. THE LIMITS OF DIFFUSION Clearly, diffusionism in anthropology and in studies of fertility change are distinctly different beasts. Where diffusionism in anthropology was concerned with changes that take place over centuries, diffusionism in studies of fertility change is concerned with changes that take place over decades or even years. Where diffusionism in anthropology was concerned almost exclusively with the spread of cultural elements from one society to another, diffusionism in studies of fertility change gives at least equal attention to the spread of knowledge and ideas concerning contraception from one person to another within populations.8 In its heyday, diffusionism in anthropology was embedded in arguments about the meaning of human cultural diversity, the psychic unity of mankind, and the mechanisms of human progress. Until the advent of structural functionalism, the principal alternatives were various theories of universal stages of cultural evolution. Drawing on studies of the diffusion of new technologies, diffusionism in demography is embedded in much more focused arguments concerning the causes of fertility transition. In these debates, it has a close affinity to theories of ideational change and an ambiguous relation to microeconomic theories of the demand for children (van de Kaa, 1996:420–422). Nevertheless, the two diffusionisms share some core ideas. Both are in their origins theories of “social imitation”9 modeled on contagion (Rosero-Bixby and Casterline, 1993:163–164; Montgomery and Chung,

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Diffusion Processes and Fertility Transition: Selected Perspectives 1999:167). Both are historicogeographical as well. The operation of diffusion leaves behind, and can be studied through, characteristic patterns of distribution in time and space. It seems not unlikely, therefore, that “the limits of diffusionism” (Kreager, 1998) in demography are related to the limits of diffusionism in anthropology. These limits turn on arguments that birth control is not and cannot be new and that the meanings of birth control technologies change as they move from one culture to another. On the Novelty of Birth Control Cleland and Wilson offer the strongest claims for the novelty of contraception within marriage in pretransition societies. To begin with, they argue that “[t]he conscious exercise of birth control within marriage in its modern parity-specific form is probably absent in most traditional societies” (Cleland and Wilson, 1987:27). The evidence for this claim is diverse. In some cases, “natural fertility may be inferred with confidence from the age pattern of fertility.” In other cases, surveys find “[v]ery low levels of knowledge of any method of contraception” (1987:13). That the practice of parity-specific birth control within marriage was genuinely absent is supported by the fact that the level of fertility is not adjusted to the economic value of children for their parents. The absence of birth control within marriage can therefore be regarded as a real absence rather than as a consequence of “a universally high demand for children” (1987:11). Anthropologists have expressed serious reservations about the novelty of parity-specific birth control for some little time. These reservations rest not on scattered ethnographic observations, but rather on fundamental theoretical principles. Ethnographers do not deny that Western contraceptive devices are new. Nor do they deny that it would be useful to trace their spread in societies into which they are introduced.10 However, like Cleland and Wilson, they recognize that parity-specific contraception can be achieved in the absence of modern contraceptives. And they argue that modern contraceptive technologies can be used for purposes other than the control of completed family size (see below). If family planning goals are separated from the means employed, two critical issues remain. One is the occurrence of parity-specific contraception. The other is the relation between family size goals and other family planning concerns. In the conventional view of family formation (e.g., Easterlin, 1978, 1983; Bulatao et al., 1983), deliberate control of family size occurs in populations in which the supply of children exceeds the demand and the costs of fertility regulation are not prohibitively high. The supply of children is a group characteristic, the product of exogenous mortality and the biology of reproduction as modified by cultural norms. The gender of children usually is ignored. These propositions combine to support the pre-

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Diffusion Processes and Fertility Transition: Selected Perspectives conception that the conscious control of fertility within marriage takes only one form, the control of family size through parity-dependent contraception (Bongaarts, 1978). Only if conscious control of family formation is limited in this way to parity-specific contraception does it make sense to think of it as either present or absent (see Polgar, 1972). However, though the presumption that effective control of fertility requires modern contraceptive technologies has a degree of plausibility,11 the claim that the supply of children is the product of “natural fertility” and exogenous mortality is clearly false. With it goes the presumption that fertility in pretransition populations is universally natural (see Carter, 1998:256ff). The anthropologist Susan Scrimshaw (1978, 1983) argued in general terms that high infant mortality might be taken as a response to high fertility rather than the other way around. In effect, various forms of infanticide may be used to control family composition as well as family size ex post facto.12 More detailed analyses build on comparative studies of family systems and household management.13 The historian Thomas Smith’s (1977) work on farm families in Nakahara, an eighteenth-century Japanese village, was one of the first studies of this kind. Seen through the lens of the age pattern of marital fertility, eighteenth-century Japan appears to conform to the criteria for natural fertility (Smith, 1977:61–62; see also Hanley and Yamamura, 1977). However, analyses of the distribution of completed family size, the age at which couples stop child bearing, the gender of next surviving children in relation to the gender of previous children, and the length of particular birth intervals, all within the framework of the movement of persons and resources into and out of stem family households, demonstrate that parents in Nakahara actively attempted to control the composition and timing of formation as well as the size of their families. They did this in part through sex-selective infanticide. “[C]ouples had a marked tendency to have [that is, to permit to live and then to register] a next child of the sex underrepresented in their present [registered] family” (Smith, 1977:65). A recent paper by the anthropologist G.William Skinner (1997) incisively synthesizes a broad range of work along these lines. As Skinner observes, “a given family system virtually specifies the relative desirability of differently configured offspring sets, thereby setting effective goals for family planning within the society” (1997:84). Again, there is considerable evidence of infanticide. The results of Skinner’s own studies of three villages in Mino Province, Japan, from 1717 to 1868 mirror Smith’s work in Nakahara. A different pattern of immediate or deferred infanticide is found in India. Much, though by no means all, of the subcontinent is characterized by virilocal joint family systems together with patrilineal

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Diffusion Processes and Fertility Transition: Selected Perspectives kinship groups, both systems with a pronounced gender bias in favor of males. In 1961–1962, when the Indian crude birth rate was in the neighborhood of 41 or 42 (Cassen, 1978:116) and the Khanna study was observing the convex age-specific fertility curves characteristic of natural fertility (Wyon and Gordon, 1977:141), data from the National Sample Survey on the incidence of surviving offspring sets with different gender compositions indicate a marked bias in favor of male children (Skinner, 1997:69–72). Skinner also details evidence of the influence of family gender composition goals on stopping behavior. In samples collected in Taiwan in 1973 and Korea in 1974, both countries with patrilineal joint family systems, parity-specific stopping ratios vary sharply with the sex composition of the surviving offspring set. In both populations, at parity four the percentage of couples who have no further children is lowest among couples who have only female children, higher for couples who have only male children, and highest for couples who have one or two daughters.14 Skinner does not address the distribution of different kinds of contraceptive practices. Indeed, he suggests that “[f]amily systems per se are silent concerning means; the overall objectives of family planning may be deduced from family system norms, but not the mechanisms for achieving them” (1997:66). Nevertheless, his concern with the gender biases inherent in different kinds of family systems provides a useful link to the volume edited by Newman (1985) on Women’s Medicine: A Cross-Cultural Study of Indigenous Fertility Regulation. Skinner appears to assume that men and women share the family planning goals specified by the family system in which they participate. The gender bias that characterizes such systems thus would consist of nothing more than the fact that men are likely, in different ways, to benefit from the system more than women. Against this perspective, feminist scholarship on the household has suggested that gender biases in fact specify different goals and strategies for men and women (Dwyer and Bruce, 1988). Cutting through considerable ethnographic diversity, many of the studies collected in Women’s Medicine describe societies with patriarchal family systems in which men do not wish their wives to control their fertility. Concerned with their own health and that of their children and with their own family strategies, women in such societies commonly see things rather differently. Constrained to manage their reproductive health covertly, they often turn to traditional substances and practices that are at once emmenagogues and abortifacients. These substances and practices allow a degree of fertility control that shelters in a space defined as menstrual regulation and regarded as the exclusive concern of women. Such fertility control may not show up in studies of the age pattern of fertility or in conventional sur-

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Diffusion Processes and Fertility Transition: Selected Perspectives veys of knowledge of contraceptive methods, but it is likely to be quite widespread, nevertheless (see also van de walle and Renne, 2001). On the Conservation of Meaning The mid-twentieth-century structural-functionalist theories of sociocultural systems that played a key role in the demise of diffusionism in anthropology do not imply that birth control technologies cannot spread across the boundaries of societies or social groups. But they do cast doubt on the idea that the meanings of birth control technologies are conserved as they move from one sociocultural system to another. Looking at the use of Western contraceptives—especially birth control pills and Depo-Provera—“through the local Gambian cultural lens,” the Bledsoe et al. (1994:86; 1998) study of contraceptive practices in a West African population is an unusually well-documented example of the ways in which the meanings of contraceptive technologies change as they are translated from one cultural setting to another. In general, contraceptive pills and Depo-Provera are not identical phenomena in the Western and Gambian contexts; “different attributes” of these technologies are salient in the two settings (Bledsoe et al., 1994:105). Rural Gambia appears to be a classic natural fertility population with high fertility and long, highly regular birth intervals. Paradoxically, it also is a population in which the Gambian Ministry of Health, Save the Children (U.S.), the Gambian Family Planning Association (an affiliate of the International Planned Parenthood Federation), and a variety of private pharmacies and personal connections have managed to make Western contraceptives surprisingly widely understood and available. The 1990 Gambian contraceptive prevalence survey found “only 6 percent of all women and 7 percent of married women were using Western contraceptives,” but these levels were “quite high in view of the area’s negligible levels of female education” (Bledsoe et al., 1994:84–85). The key observation of Bledsoe et al. is that rural Gambian women use Western contraceptives in ways that confound the expectations of the agencies that distribute them. Rather than using birth control pills and Depo-Provera to stop child bearing and reduce fertility, they employ them to manage birth intervals and enhance the ability to bear large numbers of children. Three elements of the Gambian cultural logic are crucial. First, men and women value large families. However, large families are not attained automatically if only nothing is done to prevent them. On the contrary, if they are to achieve their goals both men and women must nurture women’s reproductive capacities in the face of poor nutrition, frequent illness, and reproductive mishaps. Sec-

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Diffusion Processes and Fertility Transition: Selected Perspectives ond, Gambians continue to value long birth intervals, seeking to avoid a subsequent pregnancy until the preceding child is weaned. But, third, postpartum abstinence, the means through which this traditionally was achieved, is coming under increasing pressure, perhaps as the result of “increases in female schooling, declines in polygyny, women’s growing needs to maintain a sexual link to a supportive male, or nonpolygynous men’s growing insistence on resuming sexual relations earlier” (Bledsoe et al., 1994:88–90). In this environment, Western contraceptives are used alongside traditional contraceptives in ways that were not anticipated by outside family planning agencies and Western social scientists. They are used in part to achieve the otherwise unreconcilable goals of resuming sexual relations while continuing to maintain long birth intervals. Thus the use of all forms of contraception, traditional as well as Western, rises steadily in the months following a delivery only to drop off sharply after the 29th month (Bledsoe et al., 1994:96). It also rises as women who have been fully breastfeeding their last-born child switch to partial breastfeeding but, again, drops off sharply when the last-born child is weaned (Bledsoe et al., 1994:99). Overall, “some 55 percent of the use of Western contraception ... is found within 18 months following a birth” (Bledsoe et al., 1994:97). The use of Western contraception is especially concentrated among women who have experienced a reproductive mishap—a miscarriage or stillbirth—and, still intent on a larger family, feel that they must rest from child bearing in order to restore their reproductive capacities (Bledsoe et al., 1998). Rural Gambian contraceptive users are not the opinion leaders of diffusion theories, “a discrete group whose background characteristics set them apart” as especially educated or modern. Instead, they comprise “the tip of a moving wave of numerous temporary users who were simply using contraceptives for small slices of time to space their births. . . . Most ‘acceptors’ rapidly and predictably became ‘non-acceptors’ (and vice versa) over the sequence of pregnancy, lactation and weaning” (Bledsoe et al., 1998:21). Within this wave, the use of Western contraceptives was particularly concentrated among older women, while “most users of ‘traditional’ contraceptives” were younger women who were more likely to have some schooling. The younger women are concerned that the Western contraceptives are such powerful substances that they will put their capacity to bear subsequent children at risk, while the older women are more likely to be concerned about the “dangers of high-parity pregnancy and childbearing” (Bledsoe et al., 1994:100–102).

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Diffusion Processes and Fertility Transition: Selected Perspectives     1983:312–319). This has been given renewed impetus in the work of Watkins and her colleagues (e.g., Hodgson and Watkins, 1997; Watkins and Hodgson, 1998). 9.   Like Kroeber, Rosero-Bixby and Casterline (1993:165, n47) cite Tarde (1903). 10.   Curiously, there appear to be very few studies of this kind. The only one I have found is the geographer Blaikie’s (1975) locational analysis of the family planning program in Purnea District, Bihar, India. 11.   But see Schneider and Schneider (1992) and Santow (1993, 1995) on withdrawal. 12.   On infanticide in South Asia, see also Chen et al., (1981), Das Gupta (1987), Levine (1987), and Miller (1981). Scheper-Hughes’ (1992) study of an impoverished and economically marginalized community in northeastern Brazil provides ethnographic support for Scrimshaw’s argument. European historical studies include Fuchs (1984, 1992), Kertzer (1991, 1993), and Ransel (1988). 13.   There is an enormous anthropological literature on family or household systems, full of technical disputes. Early versions of the “developmental cycle in domestic groups” (e.g., Goody, 1958) are apparent in Lesthaeghe’s (1980) theory of “the social control of human reproduction.” For more recent work on the household, see Netting et al. (1984). For a discussion of the utility of distinguishing between families and households, see Carter (1984). 14.   For Taiwan, Skinner cites Coombs and Sun (1978). His source for Korea is Park (1983). For an elegant analysis of “deliberate birth control in [rural] China before 1970,” see Zhao (1997). 15.   For brief reviews of this work, see Carter (1999) or Pelissier (1991). Among the key texts are Lave (1988, 1989, 1991), Lave and Wenger (1991), Rogoff and Lave (1984), and Scribner (1997). 16.   For a concrete example with important implications for health communications, see Nations and Monte’s (1997) analysis of the 1994 cholera control campaign in northeastern Brazil. In this radically stratified setting, the residents of urban slums denied the existence of cholera and actively resisted the efforts of public health workers. They understood posters with the caption “Cholera, Don’t Close your Eyes to Life: Help Combat Cholera” as signaling a campaign to exterminate not the disease, but “we the cholera poor” (Nations and Monte, 1997:458–59). 17.   See also the discussions of genres of communication in Hymes (1974), Bergmann (1993:26–32), and Hanks (1996b:242–249 and passim). 18.   See also McNicoll (1985, 1988), Cain (1985), and Greenhalgh (1990). 19.   Also missing is any indication of village size. 20.   See, for example, Wolf (1972:32–3). 21.   Where marriage is hypergamous, “horizontal” should be read as “less vertical.” 22.   This is a major theme of Mayer’s (1966) classic ethnography of “a village and its region.” For a general review of the literature, see Dumont (1980). 23.   Other sources include the processes through which villages grow and produce new natural villages and the links between natural villages and agrarian ecology. 24.   Since the data used by Entwisle et al. come from a census and concern units that have headmen, it would appear that the unit of analysis in this paper is the administrative village. However, the paper does not specify this. Nor does it say anything about the relationship between the administrative village and the natural village in Nang Rong district. 25.   Much of the recent work of Watkins approximates this approach. See, for example, Kaler and Watkins (1999) and Watkins and Hodgson (1998). 26.   Linguists commonly observe that there is no one-to-one correspondence between the form of an utterance and its meaning and force. On the contrary, the sense of an utterance is spread over and inseparable from its context (see Levinson, 1983:286ff; Hanks, 1996b; Duranti, 1997; Ainsworth-Vaughn, 1998). These difficulties are compounded by changes introduced by translation.

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Diffusion Processes and Fertility Transition: Selected Perspectives 27.   On conversation analysis, see Sacks (1984), Sacks et al. (1974), Schegloff et al. (1977), and Levinson (1983:284–370). 28.   As Kaler and Watkins (1999) demonstrate, this is very much an empirical question. The aims of counselors and of clients no doubt vary from one setting to another and in any case are unlikely to correspond perfectly. 29.   See also Ferrara (1994:108–127) on “echoing” in psychotherapeutic interactions. 30.   Felicitous sessions also have relatively few occasions on which the counselor takes over the conversation with protracted explanations, and more instances in which the counselor offers extra assistance. 31.   On the cross-cultural robustness of some of the more straightforward findings of conversation analysis, see Boden (1994) and Lerner and Takagi (1999). REFERENCES Ainsworth-Vaughn, N. 1998 Claiming Power in Doctor-Patient Talk. Oxford: Oxford University Press. Alwando-Edyegu, M.G., and E.Marum 1999 Knowledge Is Power: Voluntary HIV Counseling and Testing in Uganda. Geneva: UNAIDS. Baker, A. 1985 The Complete Book of Problem Pregnancy Counseling. Granite City, IL: The Hope Clinic for Women, Ltd. Bakhtin, M.M., and P.M.Medvedev 1985 The Formal Method in Literary Scholarship: A Critical Introduction to Sociological Poetics. Translated by A.J.Wehrle. Cambridge, MA: Harvard University Press. Bergmann, J.R. 1993 Discreet Indiscretions: The Social Organization of Gossip. Translated by J.Bednarz. New York: Aldine de Gruyter. Blaikie, P.M. 1975 Family Planning in India. London: Edward Arnold. Bledsoe, C.H., F.Banja, and A.G.Hill 1998 Reproductive mishaps and Western contraception: An African challenge to fertility theory. Population and Development Review 24(1):15–57. Bledsoe, C.H., A.G.Hill, U.D’Alessandro, and P.Langerock 1994 Constructing natural fertility: The use of Western contraceptive technologies in rural Gambia. Population and Development Review 20(1):81–113. Boden, D. 1994 The Business of Talk: Organizations in Action. Cambridge, MA: Polity Press. Bongaarts, J. 1978 A framework for analyzing the proximate determinants of fertility. Population and Development Review 20(1):81–113. Bongaarts, J., and S.C.Watkins 1996 Social interactions and contemporary fertility transitions. Population and Development Review 22(4):639–682. Bourdieu, P. 1977 Outline of a Theory of Practice. Translated by Richard Nice. Cambridge, Eng.: Cambridge University Press. 1991 Language and Symbolic Power, John B.Thompson, ed. Cambridge, MA: Harvard University Press.

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