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

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.

Natural Contraception – Part 1

chart

Many women have said to me “Oh, charting is just too much bother”.  Well, is it too much bother to pencil in your eyebrows and put on lipstick before you leave the front door? This is YOUR body, it is your health we are talking about.  Once you get the blank charts, it probably will take you five minutes. Easy peezy… like tying your shoe laces!

Waking Temperature

Why do it?

  • you can see when you are ovulating
  • tell when you can have safe sex without unwanted pregnancy
  • see when you are no longer fertile (Great for when you want a “green light” for safe sex” or when you are trying to get pregnant, it is not gonna happen…
  • indicates when you will get your menses
  • potential issues with period

How to do it
glass thermometer
When you first wake up, before you drink water or anything else.  Everyday, including during your menses. If possible, take your temperature at the same time each day. Note the time on your chart. The later in the day, the higher the temperature…so if you forget to do the temperature upon waking, you need to note the time.

If your thermometer is digital, make sure to wait until it beeps.  The reading would then be more accurate. A glass thermometer, should be left in the mouth a full five minutes.  Shake it down the night before or at least remember to do so before you take the temperature for that day.

Take your temperature ORALLY.

Also note on your chart if you have had unusual events in your life, such as: stress, illness, are traveling, or you are moving. These events can affect your temperature.

 

Our Gynecological Health – Part 2

Normal VS Abnormal Bleeding

Normal menstruation lasts about five days and usually will follow a pattern, here are two variations:

Light –> heavy –> medium –> light –> very light
Heavy –> heavy –> medium –> medium –> light

Also, some women may spot (ordinarily brownish) or bleed at other times in their cycle besides actual menstruation. Spotting is one of the most misunderstood aspects of a woman’s cycle. A common mistake is to assume any type of bleeding episode is menstruation. True menstruation occurs after ovulation, about 12 to 16 days after. Any other type of bleeding is either anovulatory bleeding, what is considered normal spotting, or is symptomatic of a problem.
Ovulatory Spotting

Light bleeding may occur right around ovulation in some women. It is not only normal, but an indicator for fertility, a sign that tells where the woman is in her cycle. It results from a sudden drop in estrogen, just before ovulation. It occurs more in long-cycles.

Anovulary Bleeding and Spotting

Once in a while an egg is not released. It could be due to the estrogen not reaching the level for the egg to release. When this happens the drop in estrogen will cause light bleeding.

For women over 40, the cause is a decreased sensitivity to FSH and LH hormones. This would result in these women not ovulating. The progesterone level is not able to sustain the lining and some spotting or bleeding may occur.

The way to know if actual ovulation did occur, is to chart the temperature. As a reminder: the temperature pattern is: low before ovulation, followed by the high temperature after.

Implantation Spotting

So when a woman notices spotting rather than bleeding a week after her temperature shifts she might want to consider a pregnancy test. This may be an indication of “implantation spotting”, because as the egg burrows into the lining of the uterus, a bit of spotting may occur. If temperatures remain high for another 18 days or more, this is an indication that the corpus luteum is viable.

Breastfeeding Spotting

After the initial flow of birth has stopped, some women may have some bleeding about six weeks postpartum. This is due to the withdrawal of hormones that were high during pregnancy.

Also there may be a fluctuation of hormones while breastfeeding because of the needs of the baby. The temporary imbalance of hormones may cause women who breastfeed a few anovulatory spotting.

Other times

• After office procedures
• While on the pill
• Or during postmenopausal hormone replacement therapy

Our Gynecological Health – Part 1

First of all, we women have left all the charting of our gynecological health in the hands of our doctors. We can keep our own records, at home.

I will be posting a .pdf file of a chart you can use as a “master sheet” of your exams and an example chart to assist you in filling it out. Use it to keep track of your weight, blood pressure, general gynecological health (which would include the breast exam, pap test, vaginal culture, etc.).

Much of what we see in our doctor’s charts, may seem to be a problem, only because we women do not understand or are taught about normal feminine health. We can understand them better when we see what actually are the “true” gynecological conditions.

These “True” Gynecological conditions would be:

• Vaginal infections
• Abnormal bleeding
• Premenstrual syndrome
• Breast lumps
• Endometriosis
• PCOS
• Nabothian (cervical) cysts

“…charting enables a woman to understand her body in a practical way (Wescheler, 230)”. A woman who charts every day is so aware of what is normal for her own body, that she can actually assist her doctor determine what is not normal based upon her symptoms. Keeping the chart of her menstruation cycle assists her In well-being, and working with the doctor.

Normal Healthy Cervical Fluid VS. Real Vaginal Infections

We live in a culture that advertises douche and sprays for vaginal “discharge” giving women the idea that they are “dirty” all the time. Douching and sprays only act to confuse the identity of healthy cervical fluid and what would be a real infection.

Wescheler explains in her book, that doctors say you don’t need either. On a talk show she watched, she says that the doctor stated that the infections from these products were “…enough to send his children to college (Wescheler , 231)”. Then there is also the yeast infection products that women self-diagnose and take every month for a “recurring” problem.

But, using the chart, detection of an actual infection will be easier, and discovered earlier. You can get treatment before discomfort sets in. Secretions mid-month are normal, but late in the month may indicate infection.

Symptoms of Vaginal Infections That Can Be Distinguished from Normal Cervical Fluid
Once you have routinely charted your normal cervical fluid, an infection can be distinguished by the unpleasant symptoms that set them apart from what is normal. Vaginal infections can range from STIs (See: The Effects of Sexually Transmitted Infections on Pregnancy) to a variety of forms of Vaginitis and of course the generic “yeast infection”.

• Abnormal discharge
• Itching, stinging, swelling, and redness
• Unpleasant odor
• Blisters, warts, and chancre sores

Avoiding Infections

Besides the consequences of douching, you should not wear clothing that is damp or too tight, as these create an unhealthy vaginal environment. Also you should wear cotton underwear, or at least cotton crotch underwear as these allow your body to breathe.

For more information see: Part 2

Miscarriage – Part 2

AFTER A MISCARRIAGE

Miscarriage is a loss as much as a full-term pregnancy where the baby is stillborn. Allow yourself to grieve the loss. Those who know ahead of time, when early signs of miscarriage is observed or during premature labor, will begin the process of grieving. This is called “anticipatory grief” and it assists you to prepare for the loss. Don’t feel bad if you have a sense of relief, the uncertainty is now over and you may feel relieved your baby’s ordeal is over.

Other people may not understand your sense of loss, unless they too have had a miscarriage. You may feel alone and isolated. Don’t keep to yourself as this can add to your feeling of doubt, and sense of self-blame.

Many people will expect you to ‘to be back to normal and may say things like ‘aren’t you over this yet?’ or ‘Buck up—no use crying over spilt milk!’ Because you are still grieving so intensely, these remarks can make you wonder if your feelings are silly or unjustified (41)”. Try to surround yourself with people who will listen and care, avoiding those people who are very insensitive.

If the baby miscarried late in the second trimester, you may have memories to grapple with. Such as, when you first heard you were pregnant, the ultrasound that showed you the baby is a boy or girl, and when you first felt the baby move. These types of things are important things to remember in the process of grieving.

You may wonder how long this process will take. It depends upon you and how well you work through the grieving process! Allow yourself the time to work through the shock, anger, denial, your memories, etc.

REFERENCES:

Davis, Deborah L. PhD. Empty Cradle, Broken Heart: surviving the death of your baby. (1994) Fulcrum.

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

Exercise for Pregnancy Health

Throughout the pregnancy year (pre-natal through post-partum) the woman’s body is in physiologic adaptation. Pregnancy is not an excuse to become sedentary, rather a time to “amp up” the exercise program. Exercise increases cardiac output, increases oxygen consumption, and changes the blood-flow distribution.

Doing a good exercise routine will not only assist the body in adapting to pregnancy, but assist in labor preparation. Your body’s muscular / skeletal structure changes in pregnancy. To have the ability, strength, and fortitude for birth a woman should do stretches, walking, squats, and other routines of exercise.

Doing these will also prevent many of the problems of pregnancy. Some of these would include:

• Calf cramping
• Tight back muscles with back fatigue and pain.
• Swelling of the ankles
• Pressure on the bladder
• Finger tingling or numbness
• Discomfort of the upper back due to breast size changes
• Spasms in the groin
• Itching due to stretched skin
• Tightening of the hip flexors (muscle group)
• Pressure and hyper-extended knees
• Sway or hollow back

There are some women who should not be doing exercise, especially rigorous exercise, during pregnancy. Also, each pregnancy should be assessed individually. Consult with your healthcare provider before you start an exercise program. If you had regularly exercised prior to pregnancy it would still be wise to talk to your healthcare provider.

For the childbirth education course, exercises that are included may differ greatly than a full-on prenatal exercise program (unless the instructor is certified in the latter. In a childbirth education coursework, the exercises emphasized are those that would prepare for delivery, reduction of third-quarter pregnancy discomforts, and enhanced post-partum recovery. These are not intended as the sole exercise done by a pregnant woman but as an addition to the physical activity already being done by the pregnant woman.

The first portion would address posture. Good posture is important not only for standing, but also sitting (whether in a car, or at the computer). After posture would be the Pelvic-rock, Squatting, and abdominal Strengthening; along with several stretching exercises for the legs, buttocks and arms.

Recommended recreational exercises would include:

Walking (varying the pace each time), running, cycling, and dancing (especially belly dancing).