The Vision

CHAIR STRADDLE

It has been my long-term goal, to start the work of Childbirth Education on the Rosebud Reservation, then expand the birthwork to local native women assisting families and extended family in childbirth.  This vision includes a mobile bus that would be able to reach even the most rural of communities to assist in health care for pregnant and post-partum women, and a free-standing childbirth center.  BIG dreams!

Today, I was thinking “What are the obstacles for young women who may be interested in becoming a Doula?” Well, first it would be the funding necessary to have the training as a Doula. So I set-up a scholarship funding campaign on Go Fund Me.

The campaign is designed to raise money for a minimum of 10 women. I believe that is a good start!  If you are interested in supporting my vision, here is my campaign: https://www.gofundme.com/rstdoulas

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 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?