Cultural Perspectives on Childbirth

co sleeping

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

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Birth Trauma Part 3

According to Cheryl Tatano Beck, traumatic birth is defined as “an event occurring during the labor and delivery process that involves actual or threatened serious injury or death to the mother  or her infant. The birthing woman experiences intense fear, helplessness, loss of control, and horror” she had later revised that statement to include the woman feeling stripped of her dignity.

What is the cause of women perceiving their birth experience as traumatic? It is the systemic elimination of protective care during the birthing process.

In Beck’s study of 40 women she says that there were four themes that emerged. Theme #1 was to care for the women and treating them as human beings. Theme #2: Lack of Communication.  Theme #3 was safety. Theme #4: The ends will justify the means.

With theme One: #1 women feeling they were objectified, and treated arrogantly and with a lack of empathy. The women were #2 left alone, and abandoned. The #3 birthing mother’s needs were not met by the hospital staff. An example given was of a woman from Puerto Rico who was on all fours, when a nurse brought in 20 students to observe…without her consent.

In theme Two: #1 no one communicated with the woman in labor. They were described as having conversations with one another within earshot but not directly talking with or to the laboring mother. As if she were non-existent.

In the third theme:  the #1 laboring mothers felt that the staff (nurses and doctors) did not adequately deliver safe care. #2 The mothers were not being allowed input into the care being given for their own selves and actually fearing for their own and / or the infant’s life!

In theme Four:  entailed #1 the sense that what was endured and experienced by the mothers was the sense of being “pushed to the background” as everyone around them were celebrating the baby’s healthy birth. These women #2 felt invisible, only the infant mattered.

The experiences mothers have had led to severe post-partum trauma and depression.  Beck, Driscoll, and Watson’s book Traumatic Birth goes into detail about feedback loops [pp. 10-12] that describe the interaction of the mother and child after a traumatic birth, with a listing of the causes and consequences of the cause. Sometimes even breastfeeding is difficult, creating “…intruding flashbacks, disturbing detachments with their infants, feeling violated, enduring physical pain, and insufficient milk supply…” Often the anniversary of a traumatic birth amplifies the feedback loop.

 …

My own reaction to the shared experiences the women in this book had illustrated the barbarism of western medical professionals, a barbarism that is completely contrary to those principles I listed from the ACOG website in part #2.

The women who tell their story of childbirth weave an astounding sense of personal alienation.  It is no wonder that there is PTSD, depression, self-destructive behaviors, socially isolationistic behaviors and pelvic floor injuries as a result of the improper calloused form of care received. Many of the women feel as though they were raped, yet most had no “history of physical, emotional, and/or sexual abuse” so birth precipitated  a sense of having “the loss of the soul”.

I only touched on a small portion of the book in these three posts. In the next few blogs, I would like to address how we can alter the outcome for women in these circumstances and possibly change childbirth for women.

Birth Trauma – Part 2

What can you do to prevent problems in labor, and miscommunication with your doctor? My recommendation is to follow the recommended diet for pregnancy, exercise (for pregnant women), drink a lot of water, and attend to the prenatal visits.

Never be afraid to ask questions!

Why a certain test is being done, what does that word mean, etc. Some things I can assist you with during the Childbirth Education coursework…but asking the questions of your doctor is important. You get to know your doctor, and he/she can get to know you.

Your right as a patient is to have any procedure or test explained to you, by your doctor.

Questions such as:

-Is the particular procedure / test done because it is required?
-Who requires it?
-Why is it required?
-Is it because of doctor concern? What precipitated that concern?

Your doctor is not GOD.

If the doctor is not responding to your questions or you are not comfortable with the explanation / or attitude of the doctor you still can address the issue. Sometimes just a rewording of your question is helpful.  If still you are not being listened to, the following outlines your rights…

HIPPA law outlines a patient’s rights:

To Clear Communication

The AMA’s Code of Medical Ethics clearly states that it is a fundamental ethical requirement that a physician should at all times deal honestly and openly with patients. Patients have a right to know their past and present medical status and to be free of any mistaken beliefs concerning their conditions.
[https://www.emedicinehealth.com/patient_rights/article_em.htm#communication ]

To Informed Consent

Informed consent involves the patient’s understanding of the following:

  • What the doctor is proposing to do
  • Whether the doctor’s proposal is a minor procedure or major surgery
  • The nature and purpose of the treatment
  • Intended effects versus possible side effects
  • The risks and anticipated benefits involved
  • All reasonable alternatives including risks and possible benefits.

[https://www.emedicinehealth.com/patient_rights/article_em.htm#informed_consent ]

Within the perimeters of informed consent, the doctor ethically understands the responsibility of:

  • The patient being told what the doctor is going to do
  • That the patient is helped to understand the medical implications
  • Whether it is a minor or major procedure
  • The risks and benefits
  • Alternatives with the information about risks and benefits

The patient rights also include:

  • Freedom from force, fraud, deceit, duress, overreaching or other ulterior form of constraint or coercion
  • The right to refuse or withdraw without influencing the patient’s future healthcare
  • The right to ask questions and to negotiate aspects of treatment

    The 3rd part follows in one week…

Birth Trauma – Part 1

Many things come up during the labor and birthing of a baby. These may or may not be emergency-level events. A woman in labor is focused on the process they are involved in: birth. The woman may not be aware of what is being discussed around them, nor the things happening that may alter their ideals of the “perfect”  birth.

Here are some things that may occur:

  • Slow dilation of the cervix
  • Labor stalling
  • Movement of the baby stops
  • Blood pressure of the mother rises

Often doctors in the hospital will want to intervene. The remedies may be interventions that you really do not need.

These interventions could possibly be:

  • Monitors
  • IV insertion
  • Inducing labor (Pitocin)
  • Or even the decision to have a c-Section (read my blog post on this here: )

The first two  can be alleviated by using gravity (walking, dancing, leaning forward onto the labor bed with feet on the floor and doing squats). Usually stressors or nervousness are the cause.

With Labor stalling, if already dilated 6-7cm, it could very well be a natural stall while going into the next stage of labor or “Transition” (Balaskas 127-131). Body tension can also effect how labor progression.

Low moaning sounds are effective here, in that the vocal cords being activated relaxes the sphincter muscle group of the pelvic floor, as Ina May states ” The state of relaxation of the mouth and jaw is directly correlated with the ability of the cervix, the vagina, and the anus to open to full capacity (Ina Mays Guide, 170). The sphincter muscles will close due to stress or fear. Goer suggests that “obstetric management can obstruct progress (The Thinking Woman’s, 108)”

Remember: Babies are birthed when they are READY. Not on some sort of perceived time schedule.  This is a process that cannot be forced.

If the baby stops movement, inform your doctor. You can use “kick counts” as a method to monitor movements if you are concerned. In active labor, the baby tends to move in a spiral as baby moves into birthing position . Sometimes stopping movement for a short period of time can be an indicator of  the baby 1) shifting position 2) resting before birthing.

Blood pressure issues could be gestational diabetes, or just stress. The cause for the blood pressure rising needs to be found. High blood pressure is also a symptom of pre-eclampsia. But if you were not having signs of this condition and diagnosed in pregnancy (which is why prenatal visits are essential) then it may be something else.

Of course, water by mouth could assist in lowering the blood pressure level. Here is suggested reading for you to understand the seriousness of this condition: https://www.acog.org/Patients/FAQs/Preeclampsia-and-High-Blood-Pressure-During-Pregnancy

So now we move onto the second part of this discussion, published one week from this page.

Orange

orange-428070_1920

Citris Aurantium: Fresh Fruit

Both the unripe and ripe fruits are used in Chinese Medicine. The unripe bitter fruit is more potent. The unripe bitter fruit (zhi shi) is used for constipation or to move stagnant chi energy. It can be used to make an expectorant for coughs. This bitter fruit is NOT recommended for use in pregnancy.

The ripe fruit has multiple properties for the pregnant woman. It is high in vitamin C and when eaten with the pulp, it contains Rutin.

A Small Orange contains the following nutrients:

Amount Per  1 small (2-3/8″ dia) (96 g) 100 grams 1 fruit (2-5/8″ dia)
Calories 45
% Daily Value*
Total Fat 0.1 g 0%
Saturated fat 0 g 0%
Polyunsaturated fat 0 g
Monounsaturated fat 0 g
Cholesterol 0 mg 0%
Sodium 0 mg 0%
Potassium 174 mg 4%
Total Carbohydrate 11 g 3%
Dietary fiber 2.3 g 9%
Sugar 9 g
Protein 0.9 g 1%

 

Vitamin A 4% Vitamin C 85%
Calcium 3% Iron 0%
Vitamin D 0% Vitamin B-6 5%
Vitamin B-12 0% Magnesium 2%

 

*Percent Daily Values are based on a 2,000 calorie diet. Your daily values may be higher or lower depending on your calorie needs.

 

Sweet Orange Essence Oil

The essence oil of the sweet orange blossom can be used in a diffuser for lack of energy and / or depression. Sweet Orange is an excellent choice for women who are having difficulty in labor and who are lacking energy. Do not use the essence oil in the bath during pregnancy, and use with extreme caution with infants present. Be sure to dilute with a carrier oil, such as Sunflower or Almond.

Neroli Essence Oil
Citris bigaradia

Neroli is derived from the bitter orange blossom.  It should not be used during pregnancy, but can be used during labor and right after delivery. Neroli helps with stress, fright, exhaustion, and shock. It is also great for anxiety. An excellent choice when there are complications in labor causing the mother to be exhausted, and anxious. If there has been a traumatic birth it will assist with the shock after the birth. Use only with the advice of a trained professional who knows about aromatherapeutic treatments. Do not use in a bath and limit its use around infants.

What’s Next?

In the next few blogs I will be discussing the healing aspects and nutritional aspects of some common foods. These are beneficial for a variety of reasons and good to use in dishes, or to have whole, on your plate!

These particular foods I would recommend to include in your diet for a healthier pregnancy…

 

tomatoes-1540836_1920

These will be:

Tomatoes
Garlic
Onions
Asparagus
Cabbage
Orange
Peppers
Yams
Apples
Ginger Root
Plum

Any warnings for pregnancy and lactation will be included, and where possibility of a recipe or two. All references for these are on my reference page.

NOTE: Imagery is from free-domain imagery sites.  If I have used any images that are not free to use, please email me [rosebud.cbe@gmail.com] and I will remove them.

Pre-Eclampsia

This seems to come up a lot when women tell me their birth stories. I cringe inside, because the majority of the time it ends up with a c-Section.

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What is it?

Symptoms are: elevated protein levels in the Urine; high blood pressure or steadily rising blood pressure; headaches; swelling of ankles, face and hands; upper abdominal pain; visual disturbances; kidney, heart, or thyroid problems (Romm, 211).

Toxemia (a later stage of this condition) is life-threatening. Do not ignore these symptoms!

How can it be prevented?

A good diet
Plenty of water (plain, at least 6 Eight ounce glasses daily)
Lowering stress in your life, 2 aspects: exercise and some sort of meditative practice.

What can I do if the doctor says I am beginning to have pre-eclampsia?

For High-Blood Pressure
Eating well (see my nutrition hand-out), exercise (see my handout for exercise), and lowering stress will all assist in lowering high blood pressure when the other indicators are ruled out.  Often times women do not drink enough water and water is the first thing the ER recommends for high blood pressure.

Swelling
These are things you can do to lower the swelling:

  • Elevate your feet for 20 minutes a day
  • Lie on the left side when sleeping or resting (assists blood flow)
  • Exercise 30 minutes a day (even a long walk will help).
  • Eat more protein and salt foods to taste. You can use natural mineral waters to assist in electrolyte balancing.

Herbals: add Epson salts to foot soak, drinking nettle and dandelion infusion (assists in balancing the kidney retention and flow of fluids).

Next: TOXEMIA

 

 

Protein Foods

Protein Foods

(with the protein foods containing the most essential amino acids first).

Proteins
Eggs (preferably organic, or at least “free-range”)
Milk
Fish (preferably:
Poultry (preferably: baked, broiled or stewed)
Tofu & other beans
Oats (preferably not quick cooking)
Nuts (especially almonds)
wheat
cornmeal

Protein Food Combinations

(to assure best usage of the most Amino Acids found in the food /Proteins )

Beans + Wheat
Beans + Rice
Corn bread + Beans
Corn tortillas + Beans
Lentil Curry + Rice
Pea Soup + Wheat (bread)
Pasta + milk and/or Cheese
Cheese + Wheat (cheese sandwiches)
Macaroni + Cheese
Garbanzo dip (hummus)
Sunflower seeds, peanuts, roasted soybeans (snack foods)

_______
“Diet for a Small Planet”. Fig.14, page 176
Ibid. page 181 (Chart)

Varicose Veins

WHAT ARE THEY?

Varicose-Vein

Varicose veins occur when the valves (that keep the blood flowing one way through the vessels) have become weak, which allow the blood to pool in the veins. This “pooling” causes the veins to become lax and distended.

CAUSES:

  • May be due to diet
  • Lack of exercise
  • Heredity
  • Hormone changes can cause the laxity of the valves
  • Pregnancy can be a predisposition for some women
    -Because there is a congestion of the blood in the lower extremities due to pressure from the uterus.
    -The return of blood from the legs to the pelvic area is reduced by the heavier uterus.

They are most common in the legs, ankles and feet. They can also show up in vulva (Vulvar variscosities) and anus (as Hemorrhoids). They become more pronounced as the pregnancy advances.

The vulvar variscosities usually are not noticible until birth. Some women notice the large ones during pregnancy. A gentle birth and hot compresses applied to the large distended veins will reduce damage or trauma to the veins. Occasionally bleeding or hematoma (internal pooling of blood) can occur and will require medical care.

Hemorrhoids become evident after birth, normally. So the use of gentle birthing will help with these as well. Constipation will aggravate hemorrhoids, and should be treated (although, following a good diet will reduce constipation due to the additional fiber from foods).

Usually the varicose veins will empty quite quickly after pregnancy. They are quite common during pregnancy, and usually repair is not considered during that time.

RECOMMENDATIONS

• Eat well, and drink lots of water
• Exercise! Exercise improves the circulation, and assists in both the prevention of and treatment for varicosities.
-Brisk walks for 30 minutes each day
-Or ride a stationary bike for the same length of time as walking
-Swim
-Yoga
-Belly dance moves such as pelvic rocks, and rolling/rocking the hips in a figure-eight.
-Dance!
• At least 20 minutes twice a day with feet elevated higher than the heart
• Do NOT sit in one place for too long. This would encourage insufficient pelvic and leg circulation.
• If you have severe varicose veins use support stockings (you can find them at a drug store.
• Use visualization to reduce the size and number of the varicose veins.
• You need to consider who / what is your support. You are not superwoman, and will need support during this very exciting time in your life!

CAUTION: Never massage the varicose veins! Massaging the veins can cause clots to dislodge and lead to an embolism. Embolisms are dangerous! If you see signs of phlebitis (swelling, heat, pain, infections around the veins) you should see the doctor or midwife right away.

DIETARY RECOMMENDATIONS

Follow the “baby wise” diet . Be especially careful to eat whole grains, high quality proteins, fresh vegetable and fruits as often as you can.

• Vitamin C with bioflavonoids is vital for assisting the walls of your veins to be strong.
• Foods with high vitamin C: citrus fruits, rose hips, dark green leafy vegetbles, cherries, alfalfa sprouts, strawberries, cantaloupe, broccoli, tomatioes, and green peppers.
• An additional 2,000 mg. of C with bioflavonoids can also help
• Vitamin E also is good for the vascular system. Take 200 to 600 IU a day. If you have heart or blood pressure problems begin with 50 IU and work up to 400 IU over a three month time-frame.
• B complex vitamins. Whole grains, nutritional yeast (I take mine in orange juice), and yogurt (its helps maintain intestinal integrity ).
• Green Vegetables…romaine (stop eating the low-vitamin Iceburg variety) lettuce, butter lettuce, turnip greens, kale, collards, mustard greens, dandelion greens, and turnip greens. Steam these, do not boil!

HERBALS

• Nettle leaf tea (One herb in the “Pregnancy Tea” blend I use) . Infuse by making 1 ounce of herb to 1 quart of water and allow to steep for 2 hours. Drink a cup to up to a quart a day depending on severity.
• Garlic, onions, oatstraw, calendula, motherwort, can also be consumed. Please consult an herbalist for guidance on their use.
• Kelp. Kelp can be added to soups or taken in a tea form.
• Deficiencies in essential fatty acids may make the varicose veins worse. Take 500 mg. of one of the following oils once each day: evening primrose, flaxseed oil, black currant oil, or borage oil.

REFERENCES:

Romm, Aviva Jill. The Natural Pregnancy Book: herbs, nutrition, and other holistic choices (2003) Celestial Arts

Lowdermilk, Dietra Leonard and Shannon E. Perry. Maternity and Women’s Health Care, 9th ed. (2007) Mosby.

Stress, Part 3

Stress

stress

Stress and Pregnancy

This is a huge transitional period for the family unit, and usually characterized as stressful. Due to new roles to learn, adjustments within the family unit, communication patterns are re-established. These shifts may trigger biologic changes, hormonal function shifts, and immune system vulnerability.

The whole family unit is thrown off it equilibrium due to restructure of family roles, adjustments to family goals, physical and emotional changes that pregnancy may bring. This is the case for the average and normal situation and pregnancy. What about other circumstances or high risk pregnancy?

If the pregnancy is from an already stressful situation such as a rape or domestic violence has occurred, the stressor of pregnancy brings additional problems. Decisions need to be made to assist the mother, if other children are involved, their safety attended to.

In high risk pregnancy situation, stress is further aggravated if hospitalization is required. “High risk” is a label given to those whom the health of the baby or mother to be is threatened.

The pregnant mother’s ability to adjust and or adapt to the situation may be in jeopardy by the excessive level of stress. The mother must understand the causative factors in being labeled high risk and accept the situation in order to have a good outcome. As well as the pregnant mother, all other family members need to assess, accept, and readjust to this prognosis.

Unfortunately, pregnancy on the reservation is almost always considered high risk. This is due to poverty, gang activity, teenage pregnancy, alcohol consumption and drug abuse.

Only YOU can change this! Change the additional stressors in your life, and then you can change the outcome of your pregnancy and delivery!