Part I: As with many things in the U.S., birth and death have both become extremely medicalized. This is unquestionably reflective of our biomedicine-dominant model of thinking. We try to avoid all discussion of death and, as Merilynne Rush explains, we have moved far away from how we used to handle deaths in the home where we could be close with our family member and grieve more on our own terms.
I have always thought about birth taking place in the hospital, that is not the case in other areas of the world. For some, the majority of births take place in the home both because of tradition and also because they don’t have much of a choice and do not have access to health care/maternity services that they often need. Others may just choose to have a home birth to get away from the medicalization of birth – but still have access to the services they may need in the case of an emergency.
For the Hmong of northern Vietnam, as presented in the Al-Jazeera film by Ahlmark and Precel, maternal mortality rates are ten times higher than in other areas of the country. As stated in the film, “a battle is being fought between modernity and tradition.” A young Hmong midwife faces obstacles like cultural tradition and politics in getting Hmong women the medical care they need in order to survive. She teaches maternal health and safe birth and thinks home births are dangerous. She also recognizes the cultural and traditional importance of home births and burying the placenta underneath the mother’s bed to ensure the good health of the infant. She has to convince the mother, and more importantly, the mother’s entire family. Yet, even at the health center where she works, there is a lack of resources and mothers may have to make a six hour trip to the closest hospital for something as simple as an ultrasound. You really see how important tradition is, and how the mothers were hesitant about going and did not want to upset their families.
As for the Inuit in Northern Canada, as discussed in lecture, home births in “birthing huts” were central to their culture and they had Shaman and midwives present. It was an important ritual to name the child after a family member who recently passed, among others. The mother is the ultimate decision-maker and is in control. As Betty-Anne Daviss explains, the Inuit elders think of birth as “a community, social, and spiritual act” and the young mothers see it as a “personal act,” compared to doctors who see it “as a medical act.” Upon a change in Canada’s immigration policy in the 1970s-1980s, the Inuits’ way of birth was upended and they were forced to be “evacuated” to give birth in a hospital. There were many issues with this – costly, a very long process, care for their other children was compromised, etc. Eventually, they began to “reclaim birth” and started “The Maternity” that’s governed by the Inuit Community Board – and now approximately 92% of Inuit women give birth at home. It is now more commonly recognized that birth at home in the north is just as safe as in a hospital in the south.
The Netherlands differ from these areas in that it is a more developed country/area. Yet, in the study conducted by de Jonge, et al., over half of the subjects of the study planned to have a home birth. That is something that we are starting to see a little more in the U.S., but definitely very far from the norm. The study found that of those who planned a home birth, most were of a higher socio-economic status and were at least 25 years old. Just as with the Inuit, it was found that there was no difference in the safety of home versus hospital births, as long as some sort of maternity service is available and close. The study mentions that “maternity services in the Netherlands are set up to meet the demands for home births…”
Each of these situations puts into perspective the different cultural and traditional aspects that are considered in the event of birth. In the U.S., we seem to have lost the familial and traditional aspect of birth – to where tradition is now in the hospital.
(my photo won’t upload, so here’s a link to it) https://goo.gl/images/aWbFB6
This magazine cover very much reinforces the dominant ideas about giving birth in the United States. One of the first things I noticed was obviously “Have the BEST BIRTH.” First, as we’ve learned this week, everyone’s idea of the “best birth” will not be the same. Next, I noticed “pack a perfect hospital bag.” This is obviously supporting the assumption that everyone will give birth in a hospital – yet there’s nothing on the cover about how to have the best home birth or how to be prepared for one. I also noticed the mention of labor and delivery fears. This makes me think about how pregnancy does instill a lot of fear in us, and I think it could have something to do with our medicalization of birth and pregnancy and how far we’ve steered from what used to be a much more natural experience.