11/13/01

Cultural Appropriateness in Women\'s Health and Maternal Child Health

One of the joys of working in American Indian country is the wonderful
and unique diversity of cultural practices.   The number of federally
recognized American Indian and Alaskan Native Tribes that are identified
is over 500+. Many more are seeking recognition at this time.  In the
Phoenix Area alone, there are 40 very unique communities of individuals
each with there own special cultural /childbearing practices within each
community and each family.

One could address some of the prenatal/birthing practices within a
community, but these practices are not followed all families.  If one
has questions in their service unit it has been suggested that an AI/AN
woman or better yet, a couple, who is willing should be invited to speak
to the health care providers to share their unique views and
experience(s). 

Frequently there are even variations in different parts of the same
reservation.  Where was the couple raised? Where do they live now? Where
along an \"acculturation\" line is that couple, at present? What type of
education has the couple previously had? What is the couple\'s present
occupation? What are their family and personal values and beliefs at
present?

Some of the threads in multiple American Indian communities we have
observe and have encouraged students to do are:

> 1\) Ask the person they are working with about any special
> childbearing practices they would like to have honored.  Don\'t be
> surprised if no answer is offered.  Honor the request if made.
>
> 2\) Do not interrupt people, give them speak so they can be fully
> heard.
>
> 3\) Be patient, it is good to give time for silence and time to
> organize one\'s thoughts.   Comments may not be given when invited,
> but later on after time for family discussion.
>
> 4\) Be yourself don\'t try to become someone you are not or impose
> what you think is a custom upon the individual.

5\) Let your caring and inner heart show and people will be more willing
to share their needs and wishes with you.

6\) Many people come through an AI/AN community.  You have to put in at
least 1-2 years of time in any community to be taken seriously.

7\) Be aware that some other beliefs are special and unique to the
certain families. In some cases, it is best not to share those practices
outside of that family setting, unless permission is otherwise obtained

Examples specific to individual areas are:

[Placenta and cord:]{.underline}

> Some of the northern plains tribes, e.g., Assiniboine/Sioux of Ft
> Peck, and in the southwest save part of the umbilical cord for the
> medicine bundle of the child.
>
> In some tribal traditions the part of the cord attached to the baby,
> is utilized after it falls off.
>
>  
>
> In many tribes, the cord may be placed in a medicine bag, which the
> individual carries for life.
>
>  
>
> In some Navajo families, part of the cord is put in places around the
> camp, which helps the child to become a good weaver, horseman, or
> sheep herder.
>
>  
>
> In some Navajo families, the placenta could be placed in the ground,
> or in a sheep skin in a tree, on family Land, so that the child will
> always know and come back to his/her birth place. 

[Braided cord:]{.underline}

Some southwest tribes utilize a braided cord suspended from the ceiling
during labor. The braided cord that the Navajo women used in home births
is hung from the ceiling of the Hogan so that the parturient has
something she can use to help support her as she pushes in a squatting
position.  The baby was delivered onto soft sheep skins. 

This practice can be honored by placing a braided cord in the labor
suite or jacuzzi in the labor area.

[20 day birth cycle]{.underline}

The Hopi have a 20-day birthing cycle where the parturient stays in the
home in a quite atmosphere with both the maternal and paternal families
having special duties to care for the mother and child.  At the end of
this cycle, a special name is given to the child. 

# Others

Some Zuni utilize abdominal massage and traditional prayers during labor

Some references:\
Milligan BC, Nursing Care and Beliefs of Expectant Navajo Women.
American Indian Quarterly VIII 1984 pp 83-101.

Waxman AG, Navajo Childbirth in Transition, Medical Anthropology. 1990,
vol 12 pp 187-206.