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Whitney Countryman Lara Fields Psychology 1100 30 November 2013 Child Birth: A Cultural Understanding

One of the most universal experiences of life and one that all those who live this life must encounter is pregnancy and childbirth. Although this is a common denominator amongst cultures the process and beliefs that surround this delicate process differ greatly. To understand the diversities found within childbirth, a basic understanding of the birth process and ailments that can arise must be met. This process and the risk factors are universal for all cultures. As we take a glance into this process we will also see that there have been ups and downs when it differing viewpoints and techniques have been used. Rituals and beliefs regarding childbirth are quite different when compared amongst differing cultures, thus the ideal scenario for childbirth will also differ among cultures.

Within chapter 3 of the text, Human develop: A Cultural Approach childbirth is broken into three stages; Labor, Delivery, and Expelling of placenta and umbilical cord. (pg. 85) The first of the stages, labor, begins as we all know with contractions of the uterus to dilate the cervix. Various ways of coping are used from women to women both natural methods and medical. Once a women's cervix has reached 10 centimeters we move into delivery or the actual birthing process. After crowning, when the top of the babys head begins to exit the vagina, the women often times receives an episiotomy if in a hospital. In recent years some debate has gone on if

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this is truly a need. After the baby makes his or her arrival contractions continue until the placenta is delivered from the body. (pg. 86)

Within the childbirth process there are so many things that can go wrong such as breech presentation or a failure to progress during birth. If these issues do arise a C-section is often administered. This is a hot topic, often times, amongst pregnant women or those in the medical field. Countries that lie within northern Europe, have a medical and cultural belief that childbirth should be natural and intervention should only take place in high risk situations. Interestingly enough, these countries have lowest rates of C-section and low rates of birth complications. (pg. 88)

Delivery has been a roller coaster through the years with everything from cultural rituals to supposed "advances" in medical technology that, in its early stages, often made situations worse. Most interesting, support by a loved one or spouse has had positive effects in the delivery room. Many women have shorter and more pleasant births when the father is present. It can be surprising how greatly the psychological can influence the physical situation. Pain can also be managed with learned techniques. (pg. 94-97)

Childbirth in the human realm is a complicated and interesting process. Every mammal goes through this process but only humans go through such training to do so, or put so much thought into this process. Though you could debate natural is better than medicated, or vice versa, no one way is right for every situation, every mother or every baby. The many options available for childbirth are vast. Living in a developed country, it can often be hard to access information regarding other, or less popular, ways of birth since delivering most commonly

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happens in a hospital setting. In hospitals mothers might feel as if they have little or no say in their birth process. Though in recent years, as the text mentioned, information is slowly becoming more accessible but only in rare circumstances does this information come from medical facilities.

To speak briefly from a personal stand point, I had my first child just over a year ago. I desired to have a natural birth. I did not want to be hooked up to Pitocin or other labor stimulating drugs and desired to be free to move as I pleased. This was not my experience. My water broke at 33 weeks pregnant and my son was delivered at 34 weeks. At 3 a.m., I was woken up and told that the Labor and Delivery wing of the hospital was ready for me. I was immediately hooked up to Pitocin to start my contractions and told that I could not walk around; the rest of my water was broken because contractions were still not coming. A short five minutes after the rest of my water was ruptured I was ready to push- but my doctor had yet to arrive to the hospital. After waiting for about an hour, my doctor arrived. Shortly after I was given an epidural and after pushing only twice was given an episiotomy. My son was delivered on the third push. His skin was bright pink and his screams filled the silent room. He was breathing well but was immediately taken away. Though, I do not regret my birthing experience, and I was very grateful for the medical knowledge of the doctor who quite possibly saved my sons life I do wonder if other options were available? Could this have gone differently and could I have had even just one minute with my son? After my son was born he was given a precautionary IV. After 8 broken vessels they administered the IV straight into his umbilical cord. Because this can be very dangerous if moved it inhibited me from holding my son for some time, and allowed only brief and rare occasions to hold him afterwards. In no way am I

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opposed to medical advancements or saying that medicine should not be taken advantage of but in America, the developed country where I live, these situations have become the social norm and the birth process has become a medical procedure rather than a naturally occurring process. I believe the birthing process is such a personal, emotional and even spiritual process, or it can be if allowed to. I am grateful for my experience, and though it was not how I would have desired or imagined I eventually brought home a happy and healthy baby boy. I couldnt have asked for more.

Just as there is diversity within the culture where I reside, the diversity only grows as we venture to other cultures of the world and this cultural diversity that comes with childbirth is quite immense. Glancing at the social norms of America - going to a hospital, lots of medical invasion, disposing of the placenta, one would be almost shocked at what other countries and cultures believe about the child birth process. In Guatemala, as it states in the text previously mentioned - rather than going to school and receiving formal education to become a midwife a woman typically feel it is a spiritual calling that they receive through a dream or vision. (pg 91). Through a sample study that was done in Guatemala, all of the women who were currently assisting in community births recalled their specific dream or vision and warranted it as very spiritual and scared. In rural areas of Guatemala, nearly 95% of births are attended by a TBA, which is a traditional birth assistant, or the equivalent of a midwife. Often times this may be an untrained family member or a "Comadorna". A Comadorna is a trusted woman within the community. Because these women have no formal education it often times ends in tragedy and with the death of the infant. In most cases a Comadorna will keep rocks or candles in the birth place of a woman to ensure that it becomes a sacred space. This is because rocks in the Mayan

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culture are believed to be given sacred and spiritual powers. These rocks seem to represent the health of the women the Comadoranas are working with. One woman spoke of her experience when she came to her Comadornas door and asked if she was burning her - The Comadorna looked around to see that one of her sacred rocks was placed on the stove. When the rock was removed and cooled the pregnant woman felt fine and that she was no longer being burned. Comadornas in the Mayan culture also believe that they receive their teaching and guidance from God. It will come in a dream or if an arm or body part twitches or tingles a birth is going to happen soon. The birth process is adorned with many prayers for guidance and safety. Many times women will stuff cotton into their ears while giving birth; this will keep the bad spirits out. Pregnancy is met with many superstitions as well. A woman cannot hear or see anything or anyone die - If this happens her baby will die. If a woman hears an animal howl, her baby will howl. To avoid this many women stay in their homes the entire 9 months of pregnancy. In some cities if a midwife is not present, a woman will give birth alone and in secret. After the birth of the child comes the placenta. The cord must be cut with a red hot knife or completely burned, after it is sealed with wax of a candle. Thought to have a special relationship with the child, the placenta should be dis-guarded in a special manner. The placenta or the ashes will be buried. If anything grows where this is buried it will then become property of the child whose placenta was discarded in that location.

Where there is a new baby there is a woman who painstakingly delivered that baby. In modern culture, this process has become something that is viewed as a strictly medical process or procedure but there are others who beg to differ and it is predicted that "peace is not likely to be brokered between the two camps any time soon". Those who believe in the power of

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doctors become very passionate that they are the only route to go and those who believe in midwifery and doulas are just as passionate about how they view birth and there does not seem to be a compromise of the two in sight.

For those that agree with midwifery, they argue invasive measures are taken in a hospital setting. According to midwives, midwifery is just as safe, if not safer when handled by a trained professional. Concern about the rising maternal mortality rate is at the forefront of their reasoning. It is argued that these statistics have doubled and even tripled in some places of the United States in just the last decade, when everywhere else in the world the numbers are decreasing. Cesarean deliveries are also up in the U.S. to a whopping 29.1%. Hospitals have had grave ups and downs in the past, from completing deliveries without gloves or proper sanitation techniques, to doctors that openly admitted they were under qualified to assist in or handle a birth. The medical industry has seen many extremes and once believed it was best completely knocked women out with "twilight sleep". This practice was something that caused them to have no recollection of the experience yet during the entire labor process the bodies of these women flailed about in obvious extreme pain. These were what one could call the dark days of medical interventions in childbirth. Medicine has come a long way since the days of practices such as these. Midwifery focuses on empowering and educating the mother so that she can deliver her ideal way with the most knowledge about her options as possible. It should be noted that in recent years a valiant effort has been made by hospitals to educate woman as they prepare to birth. Many hospitals offer classes on the birth process and what will happen during your delivery. They have classes that educated a woman on a medicated approach and also some that teach postures and positions to help aid in a more natural approach. They even

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offer classes on infant care and breast feeding to help first time mothers learn about this tedious process. Though a medically assisted birth is great for some, a study done in 1997 reported that "home birth involved fewer medical interventions, including induction, augmentation, episiotomy, and cesareans". Some that are wary of midwifery think that this statistic derives from the fact that midwives take on less high risk cases and all the "risky" deliveries are brought to a hospital where these interventions are necessary.

How and where a woman chooses to birth her baby is a hot topic that most mothers are sure to have an opinion about. It can be seen from all different angles. Some women swear by a medical team who guided her through labor, others tell horror stories. The same can be found among the midwifery world. Each woman must read through the facts and possibly personal tales of women who have delivered before so that she might be able to decide what is best for her baby. Again, as I mention above I myself delivered in a hospital, I was induced 6 weeks early because my water had ruptured. I never wanted to be confined to a bed or have high medical interventions. I got all of it, but in the end I was very happy with my birthing experience. My baby and I were well taken care of and I have him because of the knowledge and care of the fine physicians. Though opinions fly rampant about this particular topic in the pregnancy world the outcomes are universal. If all goes well during birth, no matter which avenue the mother choses to take she will be presented with the same baby, with the same personality and traits as she would have if she had decided to birth differently. Choosing medicine or midwifery will not influence a childs personality, or intelligence. Though so much time and thought is put into this discussion, in the long wrong it will not influence your childs life nor will it affect their successes and failures.

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When it comes to an "ideal world" or ideal situation for pregnancy and birth experience there is no one good answer. As we have seen throughout the article every woman and culture views pregnancy and the birthing process a little differently. Each Doctor, Douala, and Midwife will also come with their own set of ethics; what is right and what is wrong for the process of delivery, what is okay and what is not. Each woman will want to get something different out of her birthing experience. One woman might completely hate being pregnant and want the doctors to take complete control, to take the driver seat so that she need not make any decisions. Another woman might view pregnancy as beautiful and want to embrace every moment and have a say in every decision about her unborn child and labor process. This particular woman might see need to incorporate faith or cultural beliefs into her birth experience. The possibilities of what a woman could want and what is "ideal" to her, are endless, yet this is the key. In an ideal world, every woman would get the pregnancy experience and be allowed to birth in the way that she desire. In "Birthing Ethics: What Mothers, Families, Childbirth Educators, Nurses, and Physicians Should Know about the Ethics of Childbirth" it talks about exactly that. It refers to what is "good" and what is "bad" and discusses that what is "good" to one woman, Doctor or Douala, might be "bad" to another. The writers of this article urge readers to read through the comments of an article that presented itself in the New York Times a few years back. "Read through these comments and you will see moral judgments everywhere. Advocates of home birth are called granola heads, ignorant, and child abusers; those who favor hospital birth are accused of being uninformed and of put ting their babies at risk by subjecting them to routine medical interventions, including induction and rupture of membranes." (Jennifer M. Torres) This statement about the comments left for that

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article only echo that fact that the only ideal world that can exists amongst this topic is for a woman to have her own personal ideal birth. Though there is no ideal scenario, one ideal outcome in which all mothers would be in agreement on, is that they have a healthy baby no matter what avenue they decide to take for pregnancy and birth. In one particular study done by University of Alabama, 17 women were interview on their birth experience. All women chose previously not to receive medication and all were met with this desire. Not surprisingly, all women reported a positive birth experience. "The overriding theme in each woman's birth story that made the experience positive was the ability to control her body during labor and influence the environment in which she labored and gave birth." (Amanda M. Hardin). Though this study was of women who chose not to receive medications, such as an epidural, I truly believe that this above statement could apply to majority of women in the fact that, if they chose an elective Cesarean and were able to do so, their experience would have been positive and if a women chose to have a home birth, and was able to do so her experience would have been positive as well. The key here is that the women were able to make the choice of what they wanted.

So many women today come out with negative birthing experiences. They feel as if they could not voice their opinion or that they were unheard, they might feel as if help wasn't give when asked, or that they were not in the driver seat. If more doctors or midwives saw their patient as a client and truly wanted to serve the patient for not only their medical needs but their personal and emotional needs as well in this very private and special affair, more women would come out knowing they had a choice and say in what happened. The women would also come out with more positive and joyous experiences. Even if all went awry and a woman who

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wanted a natural birth ended up with a cesarean, if she knew all attempts were made to progress labor in the manner that she desired and that she was a part of the decision making process, I believe that her experience would still be positive and looked upon with fondness rather than frustration and regret.

The many variables that come into play during the process of childbirth make it a complex one. Though cultural, emotional and spiritual preferences and beliefs vary a great degree, the commonality of process will always be found amongst varying woman. Understanding this process is the basis of, and only furthers our understanding of developmental psychology. Through this topic of childbirth, one can then begin to learn about topics that come later in human development.

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Works Cited
Amanda M. Hardin, Ellen B. Buckner. "Characteristics of a Positive Experience for Women Who Have Unmedicated Childbirth." The Journal of Perinatal Education (2004). Web. 18 11 2013. Bernon, Bernadette. "BoatU.S Crusing Logs Archives." 17 August 2001. http://www.boatus.com/cruising/ithaka/bb071.asp. Web. 13 October 2013. Dundes, Lauren, ed. The Manner Born: Birth Rites in Cross-cultural Perspective. Walnut Creek, CA: AltaMira, 2003. Web. Lothian, Judith A. "Home Birth: The Wave of the Future?" Journal of Perinatal Education 15.3 (2006): 43-46. The Journal of Perinatal Education. USA.GOV, Summer 2006. Web. 28 Oct. 2013. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595304/>. McKinley, Amanda. "Pregnancy and Newborn." n.d. http://www.pnmag.com/pregnancy/passport-to-pregnancy-traditions-from-around-the-world3/. Web. 13 October 2013. Newman, Taylor. "Parenting." 30 August 2012 . american-hospital-birth-not-safe-you-thinkwhat-gives-and-what. Web. 28 October 2013. Torres, M. Jennifer; Raymond G De Vries. "Birthing Ethics: What Mothers, Families, Childbirth Educators, Nurses, and Physicians Should Know About the Ethics of Childbirth." The Journal of Pernatal Education (2009). Web. V.WALSH, LINDA. "Beliefs and Rituals in Traditional Birth Attendant Practice in Guatemala." JOURNAL OF TRANSCULTURAL NURSING (2006): 148-154. Web.