Part I. The ways people across the world medicalize birth reflects a wide variety of different cultural ideas, specifically about women, mothers, and families. In the United States, childbirth is thought of through the lens of ultrasounds, EFM machines, prenatal vitamins/medications, latex gloves, IVs (and other tubes), and a swarm of medical assistants following the orders of a head physician wearing a sterile mask. We place all of our faith, decision-making, and the very lives of our newly born children in medical professionals’ hands. The birthing process, while biological and natural, takes a back seat to medical training, test readings, measurements, and the will of the doctor. Mothers, especially in emergent cases, have very little say in delivery once labor has started. This loss of maternal agency represents both a huge amount of trust in our biomedical system and science, but also a lack of confidence in mothers and their families to safely bring a baby into the world. While this practice may be a blessing in disguise in many instances (I don’t know how to give birth to a healthy baby on my own, do you?), this hypermedicalization of the birthing process could be very insulting, uncomfortable, and restrictive to others from different cultural backgrounds and maternal traditions.
In traditional Inuit culture, a woman was expected to give birth at home with the assistance and advice of elders who have undergone the birthing process countless times before. The prenatal diet of a pregnant woman consisted of walrus, caribou, and other raw forms of meat native to the Inuit land, and mothers were to stay within their communities prior to, during, and after childbirth. As birth became more medicalized in Canada overtime, the government began to insist that Inuit mothers be evacuated to Southern Canada to deliver their children in hospitals stocked full of medical resources, junk food, and technological interventions. Betty-Anne Daviss examines this shift and the following struggle to regain control over the Inuit birthing process in her chapter titled “Heading Warnings from the Canary, the Whale, and the Inuit”; utilizing language congruent with different forms of logic and knowledge, she launches into a critical medical anthropological study that showcases the plight of Inuit mothers and their communities as they oppose Canadian power structures to have a say about the details of their own labor and birth (i.e. diet, place of birth, individuals in attendance, etc.) (Daviss 1996). Through the continued efforts to advocate for less evacuations by force and the establishment of the POV Maternity, the Inuit people reinforce the importance of childbirth and the role of mothers in their communities by taking back that agency to practice their own cultural traditions of in-community births.
In the Netherlands, childbirth was analyzed using a more epidemiological/population-wide approach; Jonge A. et al.’s study found that 60.7% of women from the year 2000 until 2006 planned to give birth at home in this post-industrial nation (De Jonge 2009). Through further research, they found that the number of babies that died or were admitted to a neonatal intensive care unit were the same in among those who had home births and planned hospital births, verifying the safety of home births in areas where maternity services are readily available. Despite the modern idealization of the Western biomedical system, maternity services in the Netherlands are ‘set up to meet the demand for home births’, and have quick and easy transport to hospitals if emergency transfers are needed (De Jonge 2009). By providing its citizens with access to medical resources while simultaneously encouraging personal decision-making in the birthing process, the Netherlands seems to value both modern advancement and familial preferences in regard to childbirth.
In Vietnam, birthing practices are limited by the extreme lack of fully stocked health clinics, reliable transport, and citizen mistrust of government-operated resources. Maternal choice about the place of labor is affected by the opinion of other family members, the speed of the pregnancy, the distance to a clinic, and the availability of physicians. In Nick Ahlmark and Nicole Precel’s film, an interpretive lens is used to follow one young midwife as she attempts to convince two expecting mothers to give birth at the health clinic for their safety (UNFPAasia 2011). Not only must she persuade them to trust in a governmental system that has made them skeptical in the past, but she must also attempt to navigate rocky terrain, unsure mother-in-laws, a language barrier between physician and patient, and appease long-held birthing traditions of the Hmong people. In this scenario, giving birth is something that seems to be expected of women to be capable of, and the opinions raised throughout the video reflect a naturalistic view of childbirth and the strength of intrafamilial dependence (or a reluctance to look to the country’s government/healthcare facilities for assistance).
References
Daviss, Betty-Anne. 1996. “Heeding Warnings from the Canary, the Whale, and the Inuit: A Framework for Analyzing Competing Types of Knowledge about Childbirth.” 441-473.
De Jonge, A., and B. Van Der Goes, et al. 2009. “New figures from the Netherlands on the Safety of Home Births.” An International Journal of Obstetrics and Gynaecology .
2011. The Mountain Midwives of Vietnam. Performed by UNFPAasia.
Part II. This photo from Forbes magazine highlights the extreme medicalization of childbirth in the United States. Juxtaposed to a happy mental image of a new mother smiling, holding a clean and healthy baby while being surrounded by her husband, loved ones, and a satisfied doctor standing in the corner, this image invokes feelings of fear, isolation, dehumanization, and sterility. Monitoring the mother’s and baby’s vitals with a set of tubes and machines has replaced the community-like support of other birthing methods like home births, and the scene looks anything but comfortable for the women on the bed. By placing this exposed birthing woman in a medical jungle of technological devices and physicians dressed in white, birth is being further compared to the unnatural. This ties into the greater American ideology of childbirth as a biomedical process and without intimate privacy.
I really like the way you analyzed the American culture of women delivering their babies. From my research this week, I had gained understanding of the overmedicinizating of our normal experiences with giving birth. With this knowledge, I reflected on the ways of people in other cultures, and what is normal to them. I didn’t take the opportunity, however, to consider how they might view our actions. The fact that you say they may consider it insulting is an interesting and new perspective that I was intrigued to analyze. Perhaps it would be the case that an Inuit woman would truly be offended if a team of doctors attempted to help her, assuming she is not well-enough equipped to handle the birth on her own. I would love to have the opportunity to speak with someone of a different culture than my own and see if they truly would feel this way.
The photo you included further intrigues me into this idea, as an Inuit woman may be terrified of the idea of being in a sterile corner alone with a doctor outside of her typical community engaging with her in such a way. One does not truly realize how odd this American normality is until they view it from an outsider’s perspective.
Now that I have looked at birth in other cultures compared to the United States I am beginning to second guess our approach to birth. Before I thought home births were dangerous but after more insight I understand why women chose to have them. I think it also depends on the conditions of the birth, for example Xyo from the film “The Mountain midwives of Vietnam” is only 16 years old and this is her first child which means there could be a number of complications that can occur during the birth. As the study from the Netherlands showed, older women who have had children previously do not have as many complications during home births.
There is debate about whether mothers give life to a child or hospitals giving life. From the image you added it seems that the hospitals are the ones who are really giving life, the mother is hocked up to multiple machines and the physician is the one who is facilitating the birth. This seems like a very scary situation to be in for a mother, to have your body going through incredible changes while laying exposed, hooked up to machines, and ultimately in no control of the birthing process. Do you think the way that births are executed in hospitals is also a reason why women chose to give home births?