In this activity post, I will be looking at how the Peruvian culture views births.
Brigitte Jordan examines the setting of childbirth in the American culture. In her paper, she discusses some of the common things we see in hospitals in the labor and delivery rooms. For example, we see that the woman gets a private room, usually accompanied by the woman’s husband, but could easily substituted for the father of the unborn baby, who will take their place at the head of the bed with the mother when it is time to start pushing. We see that there are nurses present who coach the birthing mother through the process. We also see that the OBGYN physicians are the ones that make all of the calls, and that the nurse cannot instruct the mother to push without the doctor’s say so. Jordan makes a point to stress that while the mother’s body is telling her to push, and while everyone in the room can clearly see that it is time for the mother to push, including the nurses, that she cannot until the doctor says so (Jordan 1992). She also mentions that while the nurse can perform cervix examinations up until the final moments, her judgement and education isn’t enough to make the final call. This is that authoritative knowledge that Jordan is talking about in her paper. The mother’s bodies knowledge doesn’t count, nor does the nurses, while they are both saying or thinking the same thing as the doctor’s, it doesn’t count.
However, things are actually quite different in Peru when looking at the setting of the birth itself. In Peru, there are no private rooms. We see that in the United States, each stage of delivery is usually done in the same room, unless there are complications or the birth requires a C-section delivery. In Peru, each stage of delivery is carried out in a different room. Rooms may be occupied with numerous beds, and the patients in that room may all be in labor at one time. There is no privacy. The first room the mother sees when giving birth in Peru is the room that is used for the dilation process. Once the mother’s cervix reaches 10cm, or complete dilation, they are moved to another room down the hall, where the actual delivery will take place. This room is too occupied with numerous birthing mothers. After the baby is delivered, the other is moved to an observation room for about two hours, and from there, moved to a post-partum care room where they will stay until they are discharged from the hospital (Kenzo 2012). This article also includes pictures of the delivery rooms, and while I have never had a child, I can definitely say that they are very different from what we see in America. In America, we have the mother in a hospital bed, laying on her back, with her feet in stirrups to deliver the baby. These pictures show chairs with stirrups that the mother will sit in to deliver the baby. These chairs kind of remind me of the reclining movie theatre seats we have. The rooms have about three-four of these chairs in them with not even a curtain separating the spaces. There are no beds, or no monitoring equipment like we would see in America.
In the article, Kenzo also discusses that birthing mothers do not get to have company during their birth. Meaning, that the babies father or the husband of the mother misses out on the birth itself. Family members are almost never allowed to accompany the patient, no matter which birthing stage she is in. Kenzo was told that the reasoning behind this was that the family members were not prepared for the ‘graphic’ nature of childbirth. However, once the mother was in the observation room, one family member could visit the mother for a short amount of time (Kenzo 2012).
It was surprising to see that in Peru, OBGYN physicians hardly ever attended the delivers, and most of the delivers are done by ‘obsetras’ which is basically the equivalent to America’s midwives. OBGYN physicians only attend deliveries if there are complications, or if the child isn’t moving through the birth canal. It was also surprising to hear that epidurals weren’t a thing in Peru. Apparently, they aren’t cost effective in hospitals, and are only used for C-section deliveries. Some private birthing clinics in Peru offer epidurals, but they are highly expensive and not covered by insurances. While epidurals are the norm in America, or at least some kind of pain reliever, there is nothing for pain offered to women in Peru.
From this, we can see that childbirth in hospitals or clinics is popular in Peru, but it wasn’t always like this. In the rural parts of Peru, particularly Ayacucho, have some of the country’s highest death rates in pregnancy and childbirth. These deaths would occur because women would give birth at home, and those trying to assist in the delivery didn’t know what they were doing, how to deliver the baby safely, or how to stop hemorrhage or infections, and didn’t know what to do if complications occurred. However, in 1999, only 6% of births took place at a clinic or hospital (Grady 2009). The health workers in Peru wanted to change that, and had started talking to the community, asking what the clinics were doing wrong or if there was a reason why they opted to take a dangerous route and give birth at home. Their feedback was that workers at the clinic didn’t speak the local language for Ayachucho, which was Quechua. They treated patients unfairly, and didn’t let husbands anywhere near the birthing process. They also forced women to wear hospital gowns instead of their own clothes, and made women lay on their back instead of allowing them to squat to give birth. The clinic staff also threw out the placenta, instead of giving it to the family to bury (Grady 2009). A non-governmental group called Health Unlimited made sure changes were made to the clinics, allowing husbands to be more involved in the process, allowing women to wear their own clothes, let women squat or be in a position that was more comfortable for them, and made other changes that allowed their cultural rituals to be practiced. With these changes, by 2007, 83% of births were taking place at the clinics (Grady 2009).
This article gave me a lot of insight in terms of childbirth in Peru. When I first saw Kenzo’s photos, I thought the birthing chairs were strange. I didn’t think about maybe that’s what the women wanted. I also find it interesting reading this article, as the feedback from the community aligns so well with our lectures and readings for this week. Like the Hmong in Vietnam, they too had language barriers with the medical staff, and were also concerned with what the doctors would do with the placenta. I can’t help but think that maybe if the Hmong community reached out to some of the clinics and gave their feedback, that possibly more women would want to go to clinics too, for safer deliveries.
Grady, Denise. “Peru – Cultural Adaptation of Birthing Services.” WUNRN, Women’s UN Report Network, 8 Sept. 2009, wunrn.com/2005/07/peru-cultural-adaptation-of-birthing-services/.
Jordan, Brigitte. “Technology and Social Interaction: Notes on the Achievement of Authoritative Knowledge in Complex Settings .” Institue for Research on Learning, 19 Apr. 1992.