This chapter examines the most salient problems faced by developing countries as they adopt cosmopolitan obstetrics. It analyzes some usually unexamined consequences of replacing traditional low technology with the sophisticated technology-dependent methods of cosmopolitan obstetrics. The chapter is concerned with the social distribution of knowledge inherent in different levels of technology and the attendant power to make decisions. It discusses the implications of this analysis for the provision of primary health care. Explicit policies of incorporating traditional practitioners and practices into national health care systems are uncommon, except in the area of maternal and child health where considerable attention has been paid to traditional birth attendants. One significant difference between low-tech and high-tech procedures and their associated artifacts is that they have different kinds of mobility beyond their own environment. The introduction of Western technology and instruments is always based on the assumption that they have greater use value than their indigenous low-technology counterparts.