Birth cultures: A qualitative approach to home birthing in Chile

Medical Anthropology Quarterly, 2012

On the basis of ethnographic work with women from different economic and educational backgrounds in Santiago, I describe the experiences of labor and birth from the point of view of women's priorities, socioeconomic constraints, and relationships with the medical system. I specifically focus on their desires expressed during the late prenatal period and their narratives of the actual birth. Class and the differences in opportunities resulting from educational and class inequalities melt down into near invisibility as vulnerability rises and women become increasingly subjected to medical decision making. The long-standing Chilean focus on child centeredness, while shown to benefit bonding, can work to obliterate women's own desires and choices by encouraging them to "sacrifice their all" for the sake of the baby. This kind of sacrifice defines the meaning of the maternal body in Chile. I suggest further analysis of these factors is essential for an understanding of the hypermedicalized Chilean context. [Chile, childbirth, medicalization, motherhood] Some anthropologists have suggested that understanding the relationship between medicalization and women requires a multidimensional approach, one that considers technology as a product of historical, cultural, and political contexts to which women respond (Lock and Kaufert 1998:2). Others highlight the relationship among technology, medicine, medical systems, women's bodies, and body politics (Davis-Floyd 2001, 2004; Martin 2001) and the need to account for women's differentiated access to knowledge (including the technical knowledge and ideology underlying medical and hospital procedures; see Esposito 1999; Lazarus 1994). The anthropology of birth and reproduction has demonstrated the need for a more comprehensive consideration of cultural differences, power structures, meanings, and practices of childbirth in different contexts (e.g., Jordan 1993; MacCormack 1994), and the need for long-term studies that consider birth within social, medicalcultural, and political economic contexts of maternity care that tackle both women's priorities and the factors such as pain, fear, stress, and anxiety in context (Gamble et al. 2007:338-339). Martin (2001) calls attention to relevant differences in birth outcome and meanings that depend on differences in race, ethnicity, and class. In this article, I reflect on the pregnancy and birth experiences of a group of women of different classes, income, and education levels in Santiago de Chile, a

Saúde em Debate, 2022

Whether in pre-pregnancy, pregnancy, birth and/or the postnatal and neonatal periods, midwives' practices are underpinned by humanism. However, in this era of postmodernity, there is an ever-growing need for rehumanization. This article adopts an auto-ethnographic approach in order to undertake a reflective analysis on the humanization of birth based on the practice of midwifery in two different contexts, namely Quebec (Canada) and Chile. In light of the evolution of the profession in these two countries, and the influence of health policies and social movements, there are factors such as the systematic use of technology and the hypermedicalization of reproductive processes which are maintaining women's ignorance and keeping them from being able to participate in their maternity process. Women's autonomy and empowerment become a key element for their participation in decisions regarding their maternity, assistance methods, or type of care. Concurrently, midwives' autonomy is a prerequisite for fully exercising their role in supporting and assisting women in this re-appropriation of their power by means of a comprehensive approach that takes into account psychological and social aspects as well as biomedical ones. KEYWORDS Humanizing childbirth. Midwife. Empowerment. Medicalization. Quebec. Chile. RESUMO Seja na pré-gravidez, na gravidez, no nascimento, seja nos períodos pós-natal e neonatal, as práticas das parteiras são sustentadas pelo humanismo. Entretanto, na atual era de pós-modernidade, há uma necessidade cada vez maior de reumanização. Este artigo adota uma abordagem autoetnográfica, a fim de realizar análise reflexiva sobre a humanização do nascimento baseada na prática da obstetrícia em dois contextos diferentes: Quebec (Canadá) e Chile. À luz da evolução da profissão nestes dois países e da influência das políticas de saúde e dos movimentos sociais, existem fatores, como o uso sistemático da tecnologia e a hipermedicalização dos processos reprodutivos, que estão mantendo as mulheres desinformadas e impedindo-as de participar de seu processo de maternidade. A autonomia e o empoderamento das mulheres tornam-se um elemento-chave para sua participação nas decisões relativas à sua maternidade, métodos de assistência ou tipo de cuidado. Ao mesmo tempo, a autonomia das parteiras é um requisito para o pleno exercício de seu papel de apoio e assistência às mulheres nesta reapropriação de seu poder, por meio de uma abordagem abrangente, que leve em conta tanto aspectos psicológicos e sociais quanto biomédicos.

PLOS ONE, 2021

Background Despite improvements in maternal mortality globally, hundreds of women continue to die daily. The World Health Organisation therefore advises all women in low-and-middle income countries to give birth in healthcare facilities. Barriers to seeking intrapartum care have been described in Thaddeus and Maine’s Three Delays Model, however these decisions are complex and often unique to different settings. Loreto, a rural province in Peru has one of the highest homebirth rates in the country at 31.8%. The aim of this study was to explore facilitators and barriers to facility births and explore women’s experiences of intrapartum care in Amazonian Peru. Methods Through purposive sampling, postnatal women were recruited for semi-structured interviews (n = 25). Interviews were transcribed verbatim and thematically analysed. A combination of deductive and inductive coding was used. Analytical triangulation was undertaken, and data saturation was used to determine when no further int...

Journal of Nursing Ufpe Online, 2014

Objective: to analyze the reasons that lead women to choose home childbirth. Method: an exploratory study with qualitative approach, conducted at the Active Center of Being Integration, with five postpartum women who gave birth in domicile, using the analysis of the Collective Subject Discourse as technique. The study was approved by the Ethics Committee in Research, CAAE No 2983.0.000.104-09. Results: the study presented three central ideas: 1. Autonomy at parturition process; home childbirth and establishing linkages; 2. Empowerment of women in the home childbirth experience. Conclusion: there is still much to be done to ensure a safe, dignified and respectful delivery for all women, because when parturition is experienced positively, it leads women to discover a force hitherto dormant for the birth process and motivation for home childbirth. Descriptors: Home Childbirth; Qualitative Analysis; Refuge.

Health Care for Women International

This article explores what home birth mothers and midwives say about the birth experience and the interaction between mother, partner and midwife. It is based on an explorative empirical study of the narratives of seven home birth mothers and the experiences of five midwives. The authors examine how these subjective experiences can help us to understand the phenomenon of home birth. The article is grounded in a philosophy of place and feminist theory, understood within a health promotion framework. Home birth manifests itself as a place-based aesthetic experience characterised by gender, body, nature and culture. The participants spoke of the significance of giving birth at home. The authors discover that giving birth at home involves celebration, togetherness and ontological security. It also encompasses a broad understanding of risk, power structures, responsibility and co-determination. Openness about the challenges of home births can boost the position of home birth among both clinicians and the general public.

Midwifery, 2017

Background Home births are quite rare and are not supported as part of mainstream health care services in most European countries. Women who choose home as the place of birth often do so because maternity services in hospitals do not offer the options that they want. The aim of the present study is to describe women's experiences of giving birth at home and to produce a comprehensive structure of meaning regarding giving birth at home. Design A phenomenological study based on analysis of open-interview transcripts using Colaizzi's approach. Participants Women who gave birth at home Findings Women who have given birth at home experience having control over their own body, the care they are given, and the practical arrangements surrounding the birth. However, they also experience negative attitudes from other people about their decision to give birth at home, and challenges because of worries about how they and their baby will cope. During the birth women feel a sense of connection to their own body, which they trust to tell them what to do. They experience great happiness on successfully giving birth and feel connected to nature and the circle of life. Being able to celebrate with family members and be pampered by them after the birth made the women feel 'like queens'. Conclusions Women's experience of childbirth at home is one of having control over the birthing process and its environment. The main challenge is exposure to negative attitudes from others, including health care professionals. Overall, the experience was full of happiness and good feelings. We conclude that more attention should be paid to the quality of birth experiences and women's individual needs and wishes within maternity care provision.

Ameryka Łacińska Kwartalnik analityczno-informacyjny, 2021

The article tackles the issue of the shift in the model of childbirth taking place in Latin American countries. Based on the analysis of 2012 documentary film Nacer by Jorge Caballero, audiovisual material from organizations dedicated to maternity care, and selected documents and legislation it focuses on values, significances, normative principles and power relations in technological and natural childbirth models. I argue that a shift from the technological paradigm to the natural paradigm of childbirth may contribute to the abolition of patriarchal structures perpetuating violence, the women’s empowerment and the construction of a society supported by the values of respect and love for living beings.

2010

Objective: To describe women's experiences of giving birth and making decisions whether to give birth at home when professional care at home is not an option in public health care. Method: A phenomenological study. Interviews with seven women; four of them gave birth at home without professional assistant and three at hospital. Results: The essential structure shows that women live with huge contrasts between an inner and outer image of birth. They express trust towards themselves and giving birth, as well as to their own decision whether hospital care is needed or not. Birth can be empowering and strengthening, and is of importance for bonding with the child. In contrast, an outer image coming from the public and healthcare is characterized by risk, danger and fear of childbirth. Birth is viewed as something draining. The women waited with their decision where to give birth, in some cases until the contractions have started. The women felt left alone and punished. They also met supportive midwives and physicians who represented a personal perspective. In contrast, as a group, they were experienced as insecure and representative for the healthcare system. Conclusion: The implication is to meet, and give a secure care to women with contrasting views of childbirth and not only to the large majority. Midwives and physicians should establish a trustful relationship with the women and know that they can be experienced as trustful even if they do not express a positive attitude towards giving birth at home.

Journal of Human Growth and Development, 2013

Objective: to describe and analyze the culture and traditions related to pregnancy, childbirth and postpartum care of the Kukama kukamiria women, living in the Peruvian Amazon, and their experiences and perceptions of care at home compared to that received at the health center. Methods: a qualitative study based on ethnography that seeks to analyze traditional knowledge and practices of self-care, taking into account descriptions of home births attended by traditional midwives, compared to that of birth care at the health institution. Results: home delivery prioritizes women's' comfort, through the use of teas, baths and specific rituals in caring for the placenta; dietary regulations and attention to environmental aspects such as temperature and lighting are built into care. At the health facilities, routine interventions include acceleration of labor with the use of drugs, vaginal cutting (episiotomy), immobilization in lithotomy position, and the disposal of the placenta as garbage; which is perceived as inadequate and aggressive. Conclusion: a preference for traditional care is justified based on feelings of neglect and vulnerability at institutionalized health centers, resulting from the lack of consideration by the health services for the cultural and well-being specificities of the Kukama Kukamiria women.

Midwifery, 2006

to illuminate the experiences of women who have given birth at home. a descriptive design with a qualitative approach based on interviews with 12 women. The text was analysed using a phenomenological-hermeneutic method. giving birth at home meant preserved authority and autonomy whereby the women themselves ruled the situation. The women's experiences of giving birth at home can be divided into three themes, with internal variations viewed as sub-themes. The main themes were as follows: 'having faith in one's own competence'; 'choosing support on one's own terms'; and 'being at home'. The experience embraced an earthly dimension, represented by reliance on inherent natural forces, and an existential, spiritual dimension, represented by faith in life itself, expressed in terms of the sacredness of giving birth, a heavenly experience, and wisdom about life itself. the experience of giving birth at home seems to differ from findings of studies focusing on the experience of giving birth in hospital. A reasonable goal for maternity care in hospital could, however, be that all women should have the opportunity to give birth on their own terms in a supportive and calm environment, surrounded by people who can assist if needed.