This monograph is a welcome addition for advanced undergraduates and graduate students in medical anthropology, as well as for public health and other professionals interested in maternal and infant health. Set in Ladakh, located in the south-eastern portion of the north Indian state of Jammu Kashmir, Andrea Wiley deftly fuses biological and cultural perspectives to develop a truly biocultural view of pregnancy/fetal life and infancy. Previously, she reported a remarkably high frequency of low birthweight (<2,500 gm or 5.5 lbs) babies in Leh, Ladakh's high-altitude capital city (elevation 3,534 m or 11,660 ft). Here, she unifies these data to provide a truly ''biocultural ethnography''; that is, a work that illustrates that ethnography can benefit from ''considering the details and evolutionary history of human biological makeup [and] likewise, [that] human biology can never be fully understood without considering the myriad social and cultural forces that ultimately impinge on biological function'' (p xiv). This biocultural perspective permits her to show, specifically, how the high-altitude environment interacts with biological and social-cultural factors influences reproduction by lowering birthweight and raising infant mortality.
Chapter 1 is devoted to developing a biocultural perspective on infancy. She briefly reviews the environmental characteristics of Ladakh, its population history, labor-intensive agricultural production, and largely Buddhist, often polyandrous and patrilocal society. The theme that reproduction and production are inexorably intertwined is introduced here and then frequently returned to elsewhere. Several previously published models demonstrate the value of using evolutionary theory for understanding the ways in which environmental, biological, and social/ behavioral factors influence health and disease. Collectively, these show the centrality of reproduction to a society's existence and provide a strong rationale for enlarging ''reproductive ecology'' to include more than just the determinants of fertility, but also the periods of pregnancy, perinatal life, and