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

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.

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

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…

 

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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.

Women with Disabilities -The Healthcare Team- Part 1

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When do you start your Search?

The search should begin as early in the pregnancy as possible. When you do a gynecological examination is the opportune time to decide if you are able to become pregnant. Hopefully, that will occur with a doctor with whom you feel comfortable.

But if the pregnancy was unexpected, or you have not found that great doctor with whom you feel comfortable, the earliest point of time is best. It is important for the baby’s sake. It has been discovered that women who receive care late in the pregnancy or have had no prenatal care at all tend to run a higher risk of infant mortality.

Finding a doctor may be a challenge. Some will immediately advise an abortion. Other doctors will become enthused by the challenges.

You need that doctor to know you well enough to understand the way the changes of pregnancy will affect you. Health issues unrelated to the disability you have will most likely need to be addressed early.

How to Find a Doctor

You could find the doctor via those with whom you trust. You may also get recommendations from the doctor who has been working with your disability.

Evaluating the Doctor’s Practice

The recommendations of friends with whom you trust can assist you in assessing the skills of the doctor. Or listening to the impressions of the patients the doctor has had in the past.

Sometimes there may be differing experiences; it’s in this instance that the opinion of an older and well-trusted doctor in the community may come in handy. There is no singular way to assess what doctor may work for you, other than knowing what you are looking for in the care administered by a doctor.

Check the office policies, by checking with the receptionist. You can ask about fees, for normal birth and caesarian section. Ask about payment and billing, insurance the doctor will accept. You will need to know what hospital the doctor is affiliated. Also check the doctor’s flexibility with requests, such as persons allowed to attend the birth, and whether the doctor will work with you on having a natural birth. Most importantly, check accessibility, if you are using a wheelchair…are the rooms and bathrooms set-up for your ease of use. The answers to these questions may narrow the choices of whom to visit.

You could ask for only a consult, rather than a visit with a full physical examination until you have decided upon which doctor you will use. Bring with you the father-to-be or an advocate. You then will have someone to share impressions and ideas with, or who would think of questions you may have not been able to think about in your nervousness.