Birth in Somalia
Brigitte Jordan discusses “authoritative knowledge” in Technology and Social Interaction. She explains that in any given situation, specifically social situations, numerous bodies of knowledge regarding that situation exist, yet there is usually one that that carries more weight than others and can become official and superior. She does note, however, that just because a certain type of knowledge is considered authoritative, it does not necessarily mean that it’s right and the others are wrong. Yet, as has been discussed in the lecture videos, other bodies of knowledge that are not considered authoritative, can be devalued. Jordan specifically analyzes the use of technology in American obstetrics, but she explains that “where there is a different social organization and different distribution of technological resources, different characteristics will prevail” (Jordan 1992).
So what does birth look like in the country of Somalia? To get a general idea of the culture of birth in Somalia, I looked at Somalia’s “Cultural Profile” written by Toby Lewis, MD on ethnomed.org, which gives a general outline of the history and culture of Somalia. It explains that childbearing usually comes shortly after marriage, and it’s not common for Somalis to discuss when they should or should not have children – planning has “little cultural relevance.” Births mostly occur at home, with attendance of a midwife. It is tradition for the mother to stay home and indoors with the baby for 40 days, a period known as afatanbah. Female relatives visit the family to help take care of them and provide food. During afatanbah, the baby wears a bracelet made from an herb to ward off the “Evil Eye” which is the concept that someone can give another the “Evil Eye” by saying something of praise towards them and something bad could then happen to them. There is also a naming ceremony that happens usually around 2-3 weeks or at the end of the afatanbah (Lewis 2018).
I decided to look a little further into the presence of the midwife during Somali births and came across an article written in 1998 by Noreen Prendiville that goes into detail on traditional birth attendants (TBA) in Somalia. The article specifically discusses the recent support by the UN and other organizations for special training of TBAs in order to reduce the maternal mortality rates in the country. Maternal mortality usually is a result of “obstructed labour, hemorrhage, eclampsia, induced abortion or infection.” Prendiville said that families didn’t choose a TBA based off of any formal training status, and didn’t always value their opinion should they suggest professional treatment. A huge issue is access to emergency medical care, which is where the UN and other organizations were hoping to lessen that gap with trained TBAs. Prendiville went on to explain that there was little to no contact of the TBA with the mother and family prior to going into labor, unless the mother was quite sick. The TBA would traditionally be contacted as soon as labor was certain, and was responsible for bringing certain supplies, and would then stay until the placenta was delivered. The study found that the TBA’s advice was general not respected and the TBAs found that tradition rules over training. Specifically, although the TBAs expressed the importance of breast feeding and the benefits to mother and child of “early sucking,” but the mothers did not generally accept that and still gave the child sugar and water because of tradition. Overall, the study concluded that the training of TBAs will unlikely improve maternal mortality rates, but may help maternal and infant morbidity rates (Prendiville 1998).
Clearly, tradition is the prevailing authoritative knowledge when it comes to birth in Somalia. Similar to what we learned about Vietnam this week, home births are preferred and cultural traditions are extremely important to the mothers and family. The knowledge and training of medical professionals isn’t always respected.
Jordan, Brigitte. “Technology and Social Interaction: Notes on the Achievement of Authoritative Knowledge in Complex Settings.” Institute for Research on Learning. 1992.
Lewis, Toby. “Somali Cultural Profile.” Somali Cultural Profile – EthnoMed, ethnomed.org/culture/somali/somali-cultural-profile.
Prendiville, Noreen. “The role and effectiveness of traditional birth attendants in Somalia.” Evaluation and Program Planning. Volume 21, Issue 4, 1998. Pages 353-361. https://www-sciencedirect-com.proxy2.cl.msu.edu/science/article/pii/S0149718998000263