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Summary: Death Without Weeping: Chapter 7

Two Feet Under and a Cardboard Coffin

The Social Production of Indifference to Child Death.

Nancy Scheper-Hughes studied mothers living in poverty experience high rates of infant mortality over and over. Women are expected accept this fate and focus on their children that are expected to survive. Her field work strategy was participant observation. Scheper-Hughes book covers a 25-year time span where she lived in Alto de Cruzeiro. She learned Portuguese and lived amongst the people in their homes and even participated in in some of the burials of these children. She practiced cultural relativism and recognized the conditions of poverty and infant mortality intersected and has become part of their culture. She understood the cultural response to high rates of infant mortality.

In Chapter 7 of Death Without Weeping, Nancy Scheper-Hughes writes about infant mortality and mothers’ reactions Brazil. The cultural response to the high infant mortality is indifference because the infant mortality rate is so high, it has become a norm in their culture. By indifference, I mean they appear react casually and do not have the grieving reaction we expect. In Module 9.1,  we learned that motherhood has different contexts. In many cultures, the death of a child can be one of the worst things a mother can experience, but these mothers are expected to be “stoic” when their child dies and focus on their children that likely to survive.

When Scheper-Hughes expressed grief about a baby who died during her first visit to Bom Jesus, she was scolded for her reaction and was puzzled by the mother’s indifferent response to the death. In Western culture, death of an infant is considered one of the worst things for a mother to endure, but for the Alto women, they react with indifference as a survival mechanism. These mothers viewed their child’s death as “natural” and “attributed” their deaths to an “aversion to life” (Scheper-Huges 270). They do not become emotionally attached to their children unless they know they will survive. In this chapter Scheper-Hughes writes that approximately one million children under the age of 5 die each year in Brazil and an estimated 25 percent of all infant deaths in Latin America occur in Brazil (Scheper Hughes 279). Reporting and registration of the deaths require no documentation and questions are not asked about how the baby died. Almost anyone other than the mother can report a child death. Most of these infants die at home and many deaths are not even reported, thus number of infants and children that die are likely much higher. In 1982, Scheper-Hughes interviewed over 100 women to track how many births and deaths and cause of death. Many women cited being poor, hungry, access to dirty water, worthless medical care and neglect. Many women had to work, but due to a lack of child care facilities and women not allowed to bring their children to work, they would be left home alone and might not be alive by the time they arrived back home. Many births are not registered. Babies are buried in unmarked graves without a funeral. The church does not celebrate their lives and babies are not baptized when dying. The children are not dying from infectious diseases like smallpox or measles due to vaccinations. They are dying from malnutrition and dehydration from diarrhea or gastrointestinal distress from formula or powdered milk made using unsanitary drinking water (Scheper-Huges 280 and 281). Brazil was going through a time of “rapid industrialization, urbanization, and modernization,” but only the middle class and upper classes benefitted from better standards of living, medical care, day care facilities, birth control and the promotion of breast feeding (Scheper Hughes 282).

Scheper-Hughes writes about the correlation between infant survival and breast feeding (Scheper-Hughes 316). Formula is mixed with contaminated water and the babies end up getting diarrhea, which leads to dehydration and death. Women do not breast feed their children because their work outside the home makes it impossible because they work in agriculture or in the homes of the wealthy doing domestic work, which is incompatible with breast-feeding. Many mothers cannot afford to buy powdered milk or formula. Women believed their breast milk was not sufficient to nourish their baby and their milk was tainted and were not accustomed to the appearance, color, and consistency of breast milk (Scheper-Hughes 325). The colostrum was thrown away. Colostrum is nutrient dense, has antioxidants that help a baby’s immune system. Newborns are fed mingau (porridge) and breast milk is given for a very short time, but eventually the mother’s milk dries up because the baby does not nurse enough. Formula is diluted with starch filler (Scheper-Hughes 318). The following was written on the labels of the formula: mother’s milk was best, refrigeration was required after prepared, water used to prepare formula required boiling, to hold baby to prevent feeding to prevent choking, and by six month of age to supplement formula with solid foods. Sadly, many of the mothers were illiterate. Many mothers did not breast feed and if they did it wasn’t very long. Most homes had no refrigeration and mothers were not boiling the contaminated water they were using to mix the formula.

Scheper-Hughes also writes how there is an indifference to child death by church and state (Scheper-Hughes 275). She also writes an estimated “one million children younger than the age of 5 die each year in Brazil and that an estimated 25% of all infant deaths in Latin American occur in Brazil (Scheper Hughes 278). Infant deaths are underreported and most of these infants die without a medical diagnosis (Scheper-Hughes 279). Most of these infants die due to malnutrition and diarrhea (leading to dehydration) related to bottle-feeding and living in unsanitary conditions. (Scheper-Hughes 280). Even through Brazil grew economically, the better living conditions and access to “improved, medical care, immunization, birth control, and day care facilities, and the world’s largest breast-feeding promotion campaign” was not accessible to the women and children in Bom Jesus.

In “Infant Mortality and Breast-Feeding in North-Eastern Brazil” by H.I. Goldberg (et al). states that infant mortality could be reduced through breast-feeding due to the “immunological agents” in the breast milk that protect babies from “gastro-intestinal and respiratory diseases” while providing all “nutritional requirements” for the baby (Goldberg et al 105). In addition, this article mentions that breast-feeding can increase intervals between births, reducing another factor for infant mortality. (Goldberg et al 108)

The local and state government do not keep accurate records of the birth and deaths. When a women is asked how many children she has, she will respond with the number of surviving and dead children (Scheper-Hughes 285 and 286). Scheper-Hughes writes about the difficulty of finding local statistics to determine the extent of infant mortality. Even when she found records, they were not complete. She ended contacting the carpenter who builds the cardboard coffins that parents are given by the government when their child dies.

The birth rates are high because the mothers are trying “to quickly replace what has been lost.”  At the same time, these women do not have control over reproductive lives like middle- and upper-class women do. Alto women view birth control conservatively with some stating not to get married if you do not want children to not doing anything to prevent pregnancy because it is God’s will. The average women have about 10 pregnancies and end up with about 4 living children (Scheper-Hughes 331). The Catholic Church views birth control as sinful.

Per Robert J. Waldman is his article “Income Distribution and Infant Mortality,” he writes “countries with unequal income distributions have higher infant mortality” (Waldman 1291). He cites lack of accessibility to health care, lower literacy rates, and increased fertility rates as reasons for the high infant mortality. He writes “an important indicator of a family’s capacity to protect its children’s health is the literacy of the mother” (Waldman 1294). This ties into Scheper-Hughes discussion about how breast-feeding campaigns not working with the Alto women and how they could not read the warning labels on baby formula (Scheper-Hughes 318).

Bibliograhy:

Zunner-Keating, Amanda (2023). 9.1 Lesson: The Construction of Motherhood. Canvas. https://canvas.csun.edu/courses/149659/pages/9-dot-1-lesson-the-construction-of-motherhood?module_item_id=6115037

Hughes, Nancy. “Chapter 7.” Death without Weeping: The Violence of Everyday Life in Brazil, University of California Press, Berkeley, 1993.

Waldmann, Robert J. “Income Distribution and Infant Mortality.” The Quarterly Journal of Economics, vol. 107, no. 4, 1992, pp. 1283–302. JSTOR, https://doi.org/10.2307/2118389. Accessed 5 Nov. 2023.

Goldberg, H. I., et al. “Infant Mortality and Breast-Feeding in North-Eastern Brazil.” Population Studies, vol. 38, no. 1, 1984, pp. 105–15. JSTOR, https://doi.org/10.2307/2174357. Accessed 5 Nov. 2023.