Western Culture & Colonization of Birth

Western Culture

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The West encourages reading and the attendance of Childbirth Education classes, along with other strategies for birthing.  In traditional cultures women “…prepare more symbolically.  They avoid all actions and thoughts that have anything to do with ‘getting stuck’ or ‘closing up’ and work on ‘letting go’. In traditional societies, women often go to midwives to confirm the pregnancy and then again only if there are special problems… (Nichols & Humenick,145)” prior to childbirth.

Another aspect is that most women within many traditional cultures used to be more directly involved in the childbearing and child birthing aspects from a young age. Her mother or aunts and grandmother would have taught her about the processes of childbearing and childbirth during childhood and/or adolescent years.  The concepts used to have “…been integrated into her maturity into adulthood (Ibid.)”. It would have come from her experiential life and stories told to her instead of a class or books.

Unfortunately, much of this kind of experience and tradition has been lost or is no longer practiced today by women. Some of the other women will talk about this or that grandma who was a midwife, and who may have been allowed at IHS for a birth. When I have asked women, they mostly talk about a more negative experience of their childbirth, if they speak up.

Traditionally, the birth of a baby was in the home, not a hospital.  Some cultures used “a special hut [that] is constructed for that purpose ;…(Ibid)”. But today, birthing mostly takes place in a hospital setting.

Close to the reservation are border towns, where bias and prejudice color the atmosphere of birth. Due to past experiences with IHS, many women may opt to not have their babies at these hospitals. Without midwives to deliver locally, this is what women on the Rosebud (Sicangu Oyate) Reservation face today.

In border towns, the hospitals have their own regulations as to who may attend the birth. They may also decide on whether a woman can have assisted births (Nurse-midwives/doulas/or family supporters).

De-Colonization of Birth
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In the 90s, several women, including myself, were having weekly meetings regarding birth in Indian country. Each week we would have speakers come to share their stories and ideas.

I found it interesting that the biggest objections came via a native woman who was working at IHS. She bluntly stated that no midwife would work through the IHS hospital in Rosebud, if she had a say.

IHS or PHS is a government funded health organization in the United States intended specifically for native health care.  Unfortunately it has its own regulations based upon the government in which native people have been the object of clinical abuse and government sanctioned studies [such as the Eugenics Program; See: ]. The intent of these studies was to lower native populations.

Such historical actions color the way in which indigenous women see childbirth in the dominant society. It creates an atmosphere of distrust in native women, that they too would be subject to similar treatment.

And lest we forget, there have been studies that demonstrated genetic memories. So whether the Eugenics Program was known to them or not, the emotional trauma would still be triggered.

Native women feel marginalized by non-native providers of health care, due to attitudes of the providers. If native health care providers are not available, cultural competence of the health care provider that is on hand is an essential for the indigenous person giving birth. In a study conducted with first-nations women, specially the Mi’kmaq, Lothian stated that “Women need to be assured they can have trust in the birth process (Lavell-Harvard & Lavelle, 50)”.

There are native women who have become Doulas, and who are nurse-midwives. In Vancouver, BC there is a group of women from the Squamish people working to assist women [Ekw’i7tl Doula Collective]. In Minnesota there is a group of native people from the Anishinabe that is training women in Doula work, Childbirth Education, and Breastfeeding [Mewinzha Ondaadiziike Wiigaming /Bemidji, MN]. In New Mexico the first native birthing center [The Changing Woman Initiative] is being developed for  indigenous women.

 

 

 

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Cultural Perspectives on Childbirth

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Every aspect of who we are from our behaviors to our learning processes is framed by our culture. The whole idea of a “melting pot” in America where many cultures blend to become one culture, is a fallacy.  People of like cultural and ethnic background tend to gravitate towards what is similar and familiar.  It shapes their identity.

This is particularly true of treaty nations (indigenous peoples) who struggle to keep their own tribal identity. Even in the cities, away from reservations, native people gravitate toward what is familiar and comfortable (besides where else would they get some Indian Tacos?).

Every indigenous group has their own cultural beliefs, rituals and traditions. Even for pregnancy and childbirth.  How childbirth took place was shaped by cultural values, ways of knowing, and framed within ritual and belief.

Unfortunately the cultural aspects were not all preserved and kept in all tribal groups, due encroachment from white society.  This encroachment has created a rift in fabric of cultural life. “The culture in which people grow up is one of the key influences on the way they see and react to the world and the way they behave (Nichols & Humenick, 139).”

For many cultures, including the Lakota, pregnancy and childbirth is much more than just a physical act.  It is believed that a spiritual force is at work.  Concepts, customs, and traditions develop around these spiritual beliefs.

Here are some of the sites I found, for other cultures:

http://www.midwiferytoday.com/articles/immexico_healing.asp

http://www.louisianafolklife.org/LT/Articles_Essays/main_misc_wait_babies.html

http://ihst.midwife.org/ihst/files/ccLibraryFiles/Filename/000000000004/IHS%20Midwives.pdf

Multi-cultural Beliefs

Within each indigenous culture are the ideas and concepts that surround the actions of the pregnant woman, her diet, how others should act when around her.  Some ideas and traditions actually carry across into multiple cultures around the world.

One concept has to do with knots and ties. That if these were within view of a pregnant woman, or she stepped across them, it would cause the umbilical cord to be tangled at birth. Another has to do with actions of others. If you fight around a pregnant woman or with one, it causes problems with her pregnancy.

For most indigenous cultures there are concepts taught regarding the spiritual aspects of birth and early childhood. There is a belief that a female spirit that assists in childbirth, for the Lakota people, and also assists the soul of the child in “picking” the family in which they will be born.  In western society, what they call the “Mongolian Marks” is what this female makes when a spirit is born in our world.

Infants and young children (until age 5) are considered “sacred beings” and our actions with them must be tempered by this belief.  They are closer to the spirit world, in Lakota belief.

Because of the spiritual forces in play, many indigenous cultures had and still practice rituals at the birth of a child.  This is due to the understanding that childbearing and childbirth are a sacred act.

This may not necessarily be understood by present-day women within the culture, but in their soul and spirit the women do recognize that modern medicine’s “managed care” works against the traditions and ageless wisdom of their tribe.  This is true whether they have a traditional spiritual base and upbringing in their lives or they have adopted non-traditional religious practice. Their sense of “knowing” from their soul, speaks out against what is not natural and a part of the spiritual birthing process.

Next: the Western Culture & De-Colonization of Birthing

FYI for native women

Just an FYI for all of you…

 

Midwives Resistance: How Native Women are Reclaiming Birth on Their Terms

Mana Preconference/for native midwives

2 FULL DAYS:

Indigenous Midwifery: Ancestral Knowledge Keepers – $150. (Proceeds go to Native American Midwives Alliance)

When: October 14-15, 8:00-5:00PM

Indigenous Birthworkers Network Birthworkers who are Midwives, Doulas, mothers…

Midwifery is On the Rise In Native Communities

Nicolle Gonzales CNM ~ Blessingway of a Native American Midwife  Video

Midwives of Color

2018 American Indian and Alaska Native National Behavioral Health Conference

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A Good Question

What needs to happen, in order to fix a broken system? Your probably wondering what I mean by a broken system. I am talking about the care of women, and especially birthing.

In a nation that has been considered “advanced” we are so far behind the eight-ball that it becomes shameful. Our c-Section rates were seriously through-the-roof, and although some improvement has been made still higher than most “civilized” countries! The average being around 31%.

Along  with that outrageous number of c-Sections are the ever-climbing mortality rates of women in birth, predominately women of color. This is shameful in a country that is supposed to be “advanced”!

On top of both high c-Section rates, and high mortality rates for birthing, is the across-the-racial-board birth trauma. It should NEVER happen! But, we have nurses and doctors who force women into procedures, who intimidate and threaten.

The media makes it seem that birth is both dangerous and extremely painful. When that consciousness is embedded in the psyche of women, and you have a medical field that relies on mechanical means to monitor births… the stage is set. We have normalized bad birthing practices, and outdated concepts about birth.

That is without discussing the current political scenarios.

The next few blogs will address the history behind, and the current information about birthing in the United States. The outdated concepts surrounding birth practices need debunking. The normalization of bad birthing practices needs to have a light shown upon it, in order to make it STOP.

It is time to become educated,

get angry,

and create a change!

My sister site will also be publishing this information, although later, at joyousbirth

Midwife Model of Care VS Hospital Model – Part 2

doula at work

Conclusions

The Medical model of care has been dominant for a century in the northern century. “By the 1920s the United States and Canada became the first societies in human history to do away with midwifery (186)”, only to learn decades later that women still wanted midwives and some would reinvent midwifery if necessary.

In the United States – our present times, only 10% of the babies delivered are born with the assistance of midwives. Whereas, in Western Europe and the rest of the world midwives attend the majority of the births. These nations have the lowest rates of maternal and newborn deaths.

There are some variances within the models of care. Some doctors now will practice according to the midwifery model of care. Some midwives, are employed by large hospital practices where the technological-medical model of care is the rule. They use the midwives for those women who desire midwifery care but the midwives in the medical model are pressured to work in the technological-medical model of care.
This information was taken from Ina May’s Guide to Childbirth. Ina May is an internationally known Midwife, who has delivered babies and written books on Midwifery and natural childbirth. She works at THE FARM, in Tennessee.

Midwife Model of Care VS Hospital Model – Part 1

doula at work

The Midwifery Model of Care

This ancient form of birthing care approaches the idea of birth as more holistic way of care-giving, recognizing the female power of creation. It also acknowledges the holistic view with a seamless unity of mind, body, and spirit; that mother and baby are inseparable units, birth is a normal healthy process.

Visits are much longer. The Midwife is attentive to the pregnant woman, answering her questions. Care-giving, education, counseling are all a part of the Midwife Model of care.

Nutrition is emphasized as the means for a healthy pregnancy, good birth, and strong thriving babies. Companionship during labor is considered important to minimize the use of technology to intervene in the process of birth.

The Midwifery Model has not time-constraint on the process of birth. Labor has its on rhythm, “…it can start and then stop, speed up or slow down and still be normal (Gaskin, 184)”. Midwives give continuous assistance throughout the duration of labor and delivery, and postpartum support after the baby is born. Women can move freely and eat freely throughout the process of labor.

Medical Hospital Model of Care

A product of the industrial revolution, and male derived, its basis is technology and medicine. It is assumed that the body is machine-like, full of short-comings or defects (some has stated child-birth as “pathological”). Pregnancy and labor are viewed as an illness, and that to prevent harm to the mother and baby, must be treated with drugs and/or medical equipment. Also, birth MUST take place within 24 hours.

Mind and body are separate entities. Women are consigned to the bed in a supine position, hooked up to electronic fetal monitors, intravenous tubes, and blood-pressure machines. Eating and drinking, after a certain point in the labor process, are not allowed. Analgesia is administered to ease labor pains since the Medical Model of Care deems pain as unacceptable.

Office visits during pregnancy are short, and questions are discouraged. The mother must take the back seat in her concerns during pregnancy, and passive role during labor. Women are treated homogeneously, with individuality considered unimportant.

Issues Part 4

The issues that affect Lakota Native women during pregnancy and childbirth in regards to: Racism, Sexism, and Oppression?

Infant mortality is higher in teen births, birth weights of their babies lower, the possibility of premature birth and the birth defects more common in premature births. Premature birth is higher in this sector of the population, often due to violence during the prenatal period.
The rise in teen birth Indian country is alarming. “46% of Native American mothers are under 20 when they have their first child, compared with 25% of mothers of all other races . The average age for becoming pregnant has become lowered from mid to upper teenage years down to pre-teen groups of 9-12 year old girls!

“Boys and girls who experience sexual dating violence are more likely to initiate sex before age 11 ”. These issues would not have incurred had the elder women counseled and instructed their younger relatives on traditional women’s roles and young men counseled and instructed by elder males, as was traditionally done.

There were two ceremonies that were traditionally done for young girls, that are now rarely found in today’s Lakota Society. The pivotal ceremony for girls was the Isnati ceremony. This ceremony was done at a female’s first menses. The young girl would have had the instruction given by elder women regarding her role in society, especially as to virtuous behaviors, her place within society, pregnancy, and childbearing. women regarding her role in society, especially as to virtuous behaviors, her place within society, pregnancy, and childbearing.

Sexual Objectification of Native Women

Rape and domestic violence in Native populations have been on the rise, but within the teen population is another aspect to be considered: gangs. Gang rapes and gang violence is high among native youth, and the female population is especially vulnerable. Although there is a high risk, in one study it was reported that those who perpetrated dating violence did not use a condom deliberately despite “high risk activity such as sexual infidelity, involving “trains” and multiple sex partners ”.

As well as gang related violence and rape, young girls are also vulnerable to date rape. In 1994, “92% who had sexual intercourse reported as having been forced against their will ”. Women ages 16-24 experience the highest rates of rape and sexual assault. The violence that is inherent in this age group limits the ability of teenage girls to manage their reproductive health and also causes them to be vulnerable to sexually transmitted diseases.

1996, the rate of reported rape among Native women was 3.5 times higher than other races. This is just the reported rapes! Add to this population, those who have been subjected to another type of criminal activity: Sex Trafficking. It has occurred since the colonial era. It is only recently that the United States Government has classified Human Trafficking as a form of slavery.

Most of the Sex Trafficking occurs in areas near First Nation Reserves (Canada), Native American Reservations, and Alaskan Native communities. To understand the particular vulnerability of Native women to Sex Traffickers, you only need to look at the historical perspective. In the United States, the military that oversaw westward expansion ‘targeted native women for sexual assault, sexual mutilation, and slaughter’, as seen in numerous accounts of that time.

Compounding all the aforementioned issues is the accumulated impact of the historical experiences creating a “generational trauma” with increased levels of trauma response and stress that passed from one generation to the next, over several consecutive generations. The generational trauma is thought to be the ‘major contributor’ to the level of ‘poverty, violent victimization, depression, suicide, substance abuse, and child abuse’ in Indian country today. It is also thought to be the reason for generational prostitution and child trafficking in the Native families.

Traffickers exploit the areas in which this population has vulnerability. One method is to portray the sex trade as a quick way to become personally empowered and have financial independence. Another is to target those who are homeless or have been impacted by poverty.

Exploitation is done of those with mental illness, have substance abuse issues, FASD (Fetal Alcohol Spectrum Disorder), and those with who are Two-Spirit (transgender) are deliberately sought due to their vulnerability on the streets from violence, and are offered protection (Pierce and Koepplinger,3).

Next:  Part 5 – Conclusion (and references).

 

Issues Part 3

What are the issues that affect Lakota Native women during pregnancy and childbirth in regards to: Racism, Sexism, and Oppression – Part 3

After years of encroachment upon traditional healing practices, the stage was set for an Eugenics movement. This movement “… in the 20th century began as a means of controlling the perceived increase in ‘degenerate’ population and maintaining or protecting hereditarily ‘fit’ members in society from being overrun by the genetically ‘unfit.’ (Forbes, 2)” or groups that were marginalized, such as Native Americans.

Initially, the population targeted was those with low intelligence and those with physical disabilities. But, soon it expanded to “ a program to implement ‘racial hygiene’ in the United States, eugenics essentially entailed taking the principle of natural selection and enforcing it by employing allegedly ‘scientific’ means (Forbes, 2)” The concern was that the white populace were being degraded by the influx of people with racial differences. The classifications included socio-economic, class, status and race.

…policies founded on eugenic theories (sic) started to emerge, forcing procedural sterilizations and other means of population control upon people believed to be unfit (Forbes, 2-3)”. In the late 60s and through the 70s the target was Native American people. Indian Health Services began a systematic sterilization policy.

Women would go to the I.H.S. hospital, told they needed a cesarean section (for a variety of reasons), anesthetized; and when they awoke, these women found they had been given a hysterectomy, which is what happened to my friend. She stated that she was not informed of the need for a hysterectomy. She had gone to deliver her baby, the doctors examined her and stated that she needed an emergency cesarean section. She awoke, finding that she had her uterus removed. My friend’s experience was not uncommon, “…in 1975 alone, some 25,000 Native American women were permanently sterilized – many after being coerced, misinformed, or threatened .

In 1990, a former nurse at I.H.S. reported that tubal ligations were used on women who did not want the surgical procedure. Birth control also was forced upon unsuspecting females such as Depo-Provera, without informed consent, and prior to the FDA having given its approval (this would include the mentally retarded ).

Health risks of the drug Depo-Provera are high in native populations due to Diabetes, obesity, and cigarette smoking. Many who were forced to have it or Norplant administered were not informed of the risk. A secondary aspect is the cultural issues. Irregular bleeding that is caused by these drugs can prevented participation in traditional spiritual practices.

In my own research of the issues of native women in the child-bearing years I was shocked by the high numbers of cesarean sections done on this sector of women. The rate of C-Sections nation-wide is 32.8%; whereas South Dakota is around 25.3%. But, I.H.S. rates are higher than the state average, last internet search showed it at 34%.

Why is this of concern? The health risks of women in the child-bearing years due to unnecessary surgery being conducted. Childbirth is treated by the modern medical doctors as though the baby a ‘disease’ that needs to be cut-out, rather than a natural biological reproductive process. Had the traditional practices of midwifery had been continued within the native culture, allowed to flourish, there would have been very few cesarean sections necessary in our modern times.

Other Factors Regarding Childbirth in Indian Country

Next below the black woman, the native woman is recorded as 2nd to the highest in infant mortality rates . This is due to living in rural areas with poor access to proper care during pregnancy. “Poverty is an important risk factor for poor health outcomes ”.

Compounding the issues mentioned above are those of teen and pre-teen births. A female who is younger than 18 or 19 years of age are not fully developed, in other words are still growing themselves. Teenagers tend to eat poorly, are more prone to drink alcohol, smoke, and take drugs during pregnancy.

Next: What are the issues that affect Lakota Native women during pregnancy and childbirth in regards to: Racism, Sexism, and Oppression – Part 4

Issues Part 2

The issues that affect Lakota Native women during pregnancy and childbirth in regards to: Racism, Sexism, and Oppression – Part 2

With new contact with the European settlers, many natives also had died due to the diseases that came with the settlers. Millions of indigenous people died by disease they had no immunity in which to fight. Disease, along with the losses of lives through conflicts or being starved out, diminished the populous and allowed for further settlement.

Over time, some philosophical concepts arose that was thought to garner the concept of a congealed wholeness of this new settler society, such as the melting pot concept. It would never become fully congealed due to its not dealing with non-whites within the American culture, i.e. how do non-whites fit the ideal? Such as, black slaves or native people.

A second concept, cultural pluralism, was a belief where many cultures and communities “should be tolerated” and somehow would all fit under the umbrella of a somewhat fused society and therefore be protected. Cultural pluralism also did not work.

Instead, the concept of assimilation grew, that would cause all groups to conform to one single group, the now dominant white/Anglo-protestant group. “Gordon (1964) has called Anglo-conformity. The idea was that the various cultural groups were to completely shed the individual unique qualities they possessed with expedience and take on the dominant cultural ways”.

So when tribes began conforming to cultural / religious ideology of the settlers, they believed this could preserve their people. The south-eastern tribes learned this philosophy of assimilating to the dominant culture had no lasting value. They became victim to American policies of removal (the American Indian Removal Act of 1830 ), in order that the American people could take the lands upon which they lived.

Policies of American government continued to diminish the lands and societies of the native populous as the immigrants continued to pour into the new “United states”. In time, the political policy was to remove children from their family and culture, carting them off to boarding schools to forcibly assimilate the populace of the younger generation of native people to “Kill the Indian in him, and save the man ”.

Traditional Childbirth Practices

In Lakota native societies (as was true of many tribal groups), the extended family groups (Tiospayes, as it is called in Lakota society) each had their own midwives that lived within the family group, and healers that worked with women. This was attested by two interviewees whose grandmothers were practicing midwives.

The teachings of the elder women within the culture (regarding traditional childbirth practices) would have been transferred from elder female to a younger generation of females. But, over time, the use of midwives within the communities had dwindled as the older females died. In interviewing people the trail of lost information seems to have run out in the generation just previous to my own, in most communities.

The shift from the traditional mode to what we now see is due to the dominant culture forcibly removing any access to information about traditional practices through assimilation policies (i.e. Boarding Schools) and over time, access to midwives and healers through government funded hospitals (I.H.S.) policies. The final act of forced assimilation was to remove the right to spiritual practices and native medicine from the arena of health care, forcing tribal members to rely on doctors from the dominant white society.

See next week’s Part 3 – The issues that affect Lakota Native women during pregnancy and childbirth in regards to: Racism, Sexism, and Oppression?