Friday, April 18, 2008

Birth Customs

"Pay attention to the pregnant woman! There is no one as important as she!"

(Chagga saying, Uganda)

I recently finished reading the very interesting book Mamatoto. I briefly referenced this book here a few weeks ago and it was fun to finally read it. The book is essentially a look at birth in a variety of cultures (including the US). It was published by The Body Shop in 1991. Even though it is "old" it isn't really "dated" since it is a brief overview of different customs and rituals and so forth and not a lot of statistics. There are a lot of absolutely fabulous (and fascinating) pictures and illustrations. These are probably the highlight of the book. Each chapter is followed by a "black page" of "facts you don't want to know" about such things are reproductive health care policies in Romania and things like that.

One of the things that struck me about this book was that there was little distinction made between the customs of other cultures and the customs of the US. For example:

"People in Tibet believe that whether or not labour is due, a child won't come out into the world unless the star under which it's destined to be born is shining. Western medicine has developed a way of starting labour artificially, by injecting into a woman's blood a simulation of the hormone oxytocin, which triggers contractions. For several years during this century, an unusual number of women laboured between the convenient hours of nine and five on weekdays...As the Malaysians say, a baby is like a fruit; it will be born when it's ripe."

I absolutely loved seeing Western culture put into the proper context like this. Too often we see our way as THE way and forget that much of what the dominant culture views as normal for birth is not necessarily truly normal, but is instead and artifact of, or custom of, our culture. Viewed from a distance the routines of birth in American are just interesting customs--in Tibet, born when the proper star is out, in the US, born when artificial hormones are injected...

I may not be explaining myself clearly--I just found the "distance" in perspective refreshing and interesting. It reminded me of the work of anthropologist Robbie Davis Floyd whose book Birth as an American Rite of Passage explores the "ritual" elements of hospital birth in America and compares and contrasts the "technocratic" model of care with a holistic, woman-centered model of care (an example of which would be the midwives model of care). She asserts that there are many elements of hospital births that serve as rituals to reinforce the technocratic model (rather than to serve actual purposes, but instead to send cultural messages as well as to initiate the baby into the technocratic model). Examples of ritual elements include putting on a hospital gown, riding in a wheelchair, and having a routine IV. These elements serve to enculturate the woman and baby into a particular model--a ritual function--rather than an individually appropriate method of care.

Another example from the Mamatoto book that I enjoyed was as follows:

"'Home birth' can mean different things to different people. It can mean a bedroom, dimly lit and scented with myrr; a sweatbath perched on a Guatemalan hillside, or a birthing pool in an English flat; a warm fireside in a Himalayan kitchen; the packed-snow sleeping platform of an Inuit igloos; or a one-room shack in Jamaica, with a washing line dividing the family bed and the children waiting on the other side for a first glance at the baby who will be held up for them to see. When a woman gives birth at home, she and her family have a degree of control over the event; it's their domain."

In short, at home the family is on their own "turf" rather than in the "culture" and "ritual elements" of an out-of-home environment.

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