Birth Rituals
Editor's note: I have gathered descriptions of some birth rituals
from various articles in past issues of Midwifery Today. At first reading
they may seem like superstitions or fear-based or prejudicial, but given
some thought or research as to what they may actually accomplish beyond
the superficial intention, they may be quite valuable to the mother,
baby, and/or the continuance of the community and culture they live
in.
If you know of other rituals, please share them with E-News readers.
Send them to Mtensubmit@midwiferytoday.com
Guatemala
- If the baby will not come, a common remedy is to boil a purple onion
in beer and have the woman drink the liquid.
- Midwives believe the placenta needs the "heat" of the newborn
to deliver, and if the cord is cut beforehand, the placenta will rise
into the throat of the mother and choke her. If she must cut the cord
prior to the placenta delivering, the midwife ties it to the mother's
leg with a strong stout string, using many knots to keep it from rising.
- Soon after the birth, the mother eats hot chocolate and sweet bread.
She does not get out of bed for 24 hours. The only fluids she takes
are hot chocolate, hot water and chamomile tea.
- Elizabeth Withhnall, Midwifery
Today Issue 25
Central African Republic
A call-and-response song used during birth: "EI-OH mama ti mbi,
ti mbi aso mbi" ("Ei-Oh mother of mine, my belly hurts me").
The response: "Kanda be ti MO!" ("Tie up your heart,"
meaning "Tough it out").
- Jennifer Wright, Midwifery
Today Issue 32
Niger
In the Moslem tradition, a woman's genitals are not to be touched by
anyone other than the husband. The matrone (midwife) respects this custom
and rather than "delivering" the infant, she aids the labouring
woman by offering herbal drinks to stimulate contractions, sprinkles
herbs over the woman's abdomen, and recites prayers for a speedy, safe
birth.
- Phyllis Sommer, RN, Midwifery
Today Issue 32
Mexico
A pregnant woman should avoid all contact with anything death-related.
She is forbidden from attending funerals or burials and from visiting
cemeteries.
- During childbirth, it is thought that the woman's womb loses heat
and her ovaries and genitals soften, never returning to their original
position. To prevent this, some traditional midwives place themselves
between the woman's legs at the moment she is giving birth, to help
keep the heat in and curses out.
- During pregnancy, a woman must avoid cold or hot baths, using warm
water instead. Cold water is believed to affect bones and joints; the
pelvis will be rigid and this could cause a longer and more difficult
and painful labor. And varicose veins and other circulatory problems
seem to appear as a consequence of hot baths. Many also believe that
a pregnant women should not expose herself to the sun's heat or stand
near a fire, since excess heat may burn the placenta or heat the baby
and irritate it.
- A 40-day period of caring for the mother and child is considered essential
for the prevention of diseases and complications.
- Guadalupe Trueba, Midwifery
Today Issue 32
Japan
Nutrition during pregnancy is extremely important in Japan. As soon
as I told my friends I was pregnant, I often received gifts of shriasu,
a tiny white fish high in calcium. The Japanese diet is normally very
healthy, but during pregnancy a woman takes special care to increase
her calcium intake. The daily diet almost always includes shirasu, rice,
miso, and nori (seaweed).
- Debbie Treijs, Midwifery
Today Issue 32
Peru
If the placenta doesn't come out on its own, put salt on the woman's
tongue.
Angola
The Umbundu people do not take the new baby outside the home for the
first seven days because they believe the child's life is tenuous and
bad luck might befall it.
- Eliza Buck, International
Midwife Issue 2
Malaysia
The bleeding postpartum woman is considered polluted and polluting.
At the same time, she is still vulnerable to evil spirits. Therefore
she is forbidden to leave the house or participate in cooking and cleaning.
- Tina Kanagaratnam, International
Midwife Issue 3
Ghana
The mother is to close or cross her legs during the postnatal period,
based on the belief that it would reduce the air entering the body which
could result in a bleeding and/or a permanently fat abdomen.
- Yvonne Lefeber, International
Midwife Issue 4
Inuit
If mothers begin a project such a sewing she should finish it so the
labor won't be long.
- Every newborn is greeted with a handshake by everyone, even the children.
- Don't make bubbles with gum or blow up a balloon or your membranes
won't rupture.
- Don't wear a ring or have braids in your hair because this will cause
the umbilical cord to be wrapped around the baby's neck.
- Leah Qinuajuak, Midwifery
Today Issue 40
The United States
- Midwife Margaret Charles Smith was taught to place the fathers' shirt
around the birthing woman's shoulders and place his cap on her head
so the father's energy would help his woman in labor.
- Clarebeth Loprinzi-Kassel, Midwifery
Today Issue 50
- I know two midwives in Montana who won't attend a birth unless a
cat is in the house because they feel it is likely the child will not
live to its first birthday.
- Anon. E-News reader
- If my senior midwife saw a black cat on the way to a birth she would
say, "I saw a black cat on the way here, stay on your toes--we're
going to have trouble." She was always right. Something would happen
like a tight nuchal cord or a really tight shoulder, maybe a bleed.
I am not superstitious and didn't believe these things happened because
of a black cat. A few years after my apprenticeship was over I attended
a birth with another midwife. That night we came to the door and I saw
two black kittens playing. I chuckled to myself, remembering the past
and thought nothing of it. When we stepped in, a huge black cat rubbed
against my leg. I still laughed but started to feel a little concerned,
yet thought better of mentioning it to the other midwife. That birth
turned out to be the scariest birth I have been to. All was well with
mother and baby, but it was scary. I now pay attention to black cats
and when I see them on the way to a birth I "stay on my toes."
- I.Duncan
Uganda
The mother is instructed not to drink water while standing, to prevent
the baby from being born with squinted eyes.
Bolivia
Don't do any knitting while you're pregnant, as it will cause the umbilical
cord to become wrapped around the baby's neck.
- Ann Davenport, International
Midwife Issue 6
Bihar, India
If a woman's labour was not progressing she was made to drink a glass
of water in which her mother-in-law's big toe had been dipped.
- Janet Chawla, Midwifery
Today Issue 52
Two ways Midwifery Today can help you learn about and understand birth
traditions around the world:
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Check It Out!
WWW.MIDWIFERYTODAY.COM
A Web Site Update for E-News Readers
"A DISTRESSING CROSS-CULTURAL TREND is showing up
in the growing body of anthropological literature about midwifery and
birth in the developing world. From Tanzania to Papua New Guinea, anthropologists
who observe professional midwives giving prenatal care and attending
births increasingly note that, far from the midwifery ideal, professional
midwives often treat women very badly during birth, ignoring their needs
and requests, talking to them disrespectfully, ordering them around,
and sometimes even yelling at them and slapping them." Read
more about how the professionalization of midwifery has changed
birth practices in many countries, by anthropologist Robbie Davis-Floyd.
MEDICINE WOMEN, CURANDERAS and Women Doctors. Click
here to read the book review
Midwifery Today's Online Forum
I am in my final year as a student midwife (direct entry) in the UK.
It is a requirement of our course that we complete a 2-week overseas
placement. I am writing in hope that a midwife overseas would be willing
to take me on for 2 weeks. Please if you are interested contact me and
I will be able to answer any questions you may have.
- Michelle
To share your thoughts and experience, go to Midwifery
Today's Forums
Question of the Week
How important and under what conditions is a sterile field a primary
concern in delivery?
- Karen Stokka
Send your responses to:
Question of the Week Responses
Q: In my prenatal fitness class I have a G1P0 due 12-4-00 who
has intercostal neuritis. She has been adjusted by her chiropractor
with no result. Gallbladder has been ruled out. I intend to work on
her with massage and am wondering if anyone has any other suggestions
on things she may try. Acupuncture has been suggested and declined,
though she was planning to have a nerve block!
- Pam Martin, MS DONA CD, CM, apprentice midwife
A: I have served some women with a similar problem who have
had incredible results with the Feldenkrais method body reeducation
called Functional Integration. A similar, but also different, modality
is Alexander. Feldenkrais teachers are often found in larger metropolitan
areas.
- Karen Ehrlich Felton, CA
A combination of acupuncture and trigger point injections with lidocaine
and marcaine(a long-acting lidocaine) helped a client through. Her symptoms
totally resolved by one week postpartum. I believe if she had started
acupuncture earlier the injections would not have been necessary because
they were rarely required after several weeks of acupuncture therapy.
- Lynette
Q: What is the longest you have seen from full dilation to the
beginning of pushing--or to the birth of a baby? What were the outcomes??
- Nancy Wainer
A: Early in my practice as a midwife I attended a very strong
and determined woman. After reaching full dilation she had no urge at
all to push, which we saw simply as a plateau. After some hours we began
to try a variety of things: walking, squatting, stairs, nipple stimulation
to bring on stronger contractions. Nothing. After some hours the woman
wanted to try an enema, a shower, a nap, forced pushing. Nothing. She
had great energy but no pushing urges. The baby remained high and stable.
At the 10-hour mark we all agreed that this child was not budging and
went into hospital. Soon after arrival, the membranes ruptured spontaneously
(no prolapse) on the toilet. No pushing urges. Soon there was meconium,
and a drop in the fetal heart rate. The OB decided to do a scalp sample
to check blood oxygen levels, which were fine. She instructed the woman
to try pushing again. The baby began to descend. The mother pushed harder
than I've ever seen. She was in a birthing bed squat. Another hour passed
and there was some progress. Two nurses helped her curl herself into
a "C" to accelerate her effort. She pushed even harder. The
heart rate continued low, but with good oxygenation. When the head finally
crowned we found the cord tightly wrapped twice around the child's neck.
She had known that birthing was like hanging herself and it wasn't safe
to be at home! It was managed nicely in hospital with the best outcome
possible: spontaneous vaginal delivery of a vigorous female without
damage to either. It took 14 hours!
- Diane Parkin, RM
A: My water broke and I started having contractions around 10:30
one evening. I couldn't sleep that night because as soon as the contractions
started they quickly became very strong and stayed that way until I
was 10 cm around 2 pm the next day. I had an anterior lip that eventually
went away and I was having true pushing urges from about 3 cm on. My
midwife could tell that the baby had quite a severe caput early on.
I ended up pushing until 1:20 am, an 11-hour second stage. When he was
born, we realized he had been in DTA (deep transverse arrest, where
baby never does the internal rotation, so head is coming out sideways)
and he came out with an extremely molded head. I have heard of other
cases of DTA where women have ended up with c-sections and that in the
hospital they are routine for DTA. All in all mine was a 27-hr labor
with 11 hrs. of pushing.
- Andrea
My first pregnancy was at age 30. My labor began Tuesday in the wee
hours of the morning. My waters started leaking about 7:00 am. Tuesday
night after about 8 hours of hard labor, my midwife thought I was getting
close. I was at 9 cm but she said my bones were not soft. Shortly after
my contractions slowed from one right on top of the last to one every
hour. (Interestingly, my labor increased with the moon and decelerated
with the sun.) My contractions remained like this during the second
day of labor. After the sun set, things picked up again. After a second
night of hard labor, my daughter was born at 6:00 am at home--52 hours
of labor and 36 hours after being dilated to 9 cm. Because of the circumstances,
we didn't do any more vaginal exams. We monitored fetal heart tones
and my body temperature. We watched my fluids for signs of infection.
Everything was normal so we waited it out. My daughter was a bit sluggish
and tired after all that labor. She had a 1-minute Apgar of ;, 5-minute,
9; and 10-minute, 10. I never had an urge to push, although when I did
push the pain went away.
- Michelle Breen
Editor's note: More stories will be included in the next issue of
E-News.
Coming E-News Themes
1. ELECTRONIC FETAL MONITORING: Does it belong in good care during
labor? Why or why not? What are your experiences? (Issue 2:41, October
18)
2. GBS: I'm curious how other midwives counsel their clients
about GBS. Do you have any new information that would make it easier
to give better and clearer informed consent to clients? Do you have
tricks in case the culture comes back positive?
- A.W. (Issue 2:42, October 25)
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E-News received numerous replies to a reader's inquiry regarding
the quality of her breastmilk. Following are excerpts:
Breastmilk looks rather like skim milk anyway, but the best way to
increase its quality (and therefore weight gain plus general improved
health in the infant) is to follow a nutritious diet high in good-quality
fruit & vegetables, full fat dairy, nuts & seeds, fatty fish,
eggs and whole grains. The breastmilk will only ever be as nutritionally
good as the mother's diet. Supplements of Vitamin E, Evening Primrose
and Fish oils can improve milk quality, particularly in regard to the
fats. Above all don't stop breastfeeding--it is by far superior to any
formula.
- Karen McElroy, Naturopath/Herbalist
Melbourne, Australia
My daughter also fell off of the growth charts, but is very healthy
(never been sick), very active, and ahead of the charts in terms of
developmental markers. A lactation consultant with La Leche League told
me the growth charts we compare our children to are based on the growth
of babies who are formula fed! Formula is higher, by huge amounts, in
fat, protein, calories, but totally lack the antibodies and many other
things that can't be reproduced.
- Pam Martin
After a little weight loss after birth, while the milk supply is increasing,
healthy breastfed babies will gain between 4 and 7 ounces per week.
They are expected to surpass their birth weight no later than three
weeks of age. Some babies whose mothers are blessed with an abundant
supply of milk may gain faster than 7 ounces per week, but it is not
that common.
Normal breastmilk is quite watery at the initiation of a feeding, and
becomes richer during a feed. It certainly can look thinner than skim
milk at the beginning and become much creamier at the end of a good
feed. It's kind of like a four-course meal--soup and salad first, then
the entree, with cheesecake for dessert. Allow/encourage your baby to
nurse long enough so she gets her share of cheesecake.
The composition of our milk changes depending on the breastfeeding style.
Frequent nursing will result in a higher fat content than infrequent
feedings. If your daughter likes to nurse often (every 30-90 minutes),
that will encourage your breasts to make higher-fat milk.
Cigarette smoking results in lower fat content in our milk. If you are
a smoker (or live with a smoker), please quit.
- Heidi Reinhart, MD
Is the baby growing fairly consistently and is she showing all the
normal advancements for her age? Does she have at least 6 wet diapers
per day? Is she having regular and healthy bowel movement? Take a look
at your own size and your husband's--are you on the small side? If you
are uncomfortable with your doctor, maybe you need to find another one.
- J.C.
Texas
I highly recommend nettles. I began drinking a half quart a day of
nettle infusion (a very strong tea of the dried herb) when I was pregnant
with my first child eight years ago.
- Anelia, CD, CBC, CNM assistant
Your best assurance for keeping your milk supply in "good working
order" is to nurse on demand for as long as she wants, avoid all
artificial nipples including pacifiers as artificial nipples will keep
your daughter from being at the breast (and milk production is based
on the supply and demand principle: the more she nurses, the more your
breasts produce) and can cause nipple confusion which may keep her from
nursing well at the breast, eat a well-balanced diet (keeping in mind
that nursing uses an additional 500 calories a day), drink plenty of
fluids especially water and juices, and rest as much as possible.
- Dianne Oliver, LLL leader
Wrentham, MA
I am a doula and apprentice midwife and have found so much help with
things like this from La Leche leaders and a few lactation specialists.
The only caution I've needed to watch with some lactation specialists
is that sometimes they are very quick to suggest pumping when other,
less complicated methods would work just as well.
- Lis Worcester, SF
Formula babies grow at a slow but steady rate as the formula doesn't
change as their nutritional needs do. Breastfed babies usually have
a large growth spurt in the first several months of life, then slow
way down. If the doctor isn't aware of this, it appears that the child
is dropping percentiles. I have been told that the new growth charts
for breastfed babes are available on-line, but haven't found them yet.
Rest assured that the formula companies will not supply them to docs
for a long time as the charts will further emphasize the difference
in growth between natural and artificial food. If your doctor recommends
adding formula, point out that both the American Pediatrics Association
and the American Academy of Family Physicians support breastfeeding
as the ideal source of milk for at least the first year. If your babe
truly needs help growing, run to your nearest lactation consultant,
breastfeeding friendly doc or LLL.
- Lynette (a family doc)
One study (Darling study) found that breastfed boys fell below the
50th percentile around 8 months and girls at 6 months. Girls fell below
the 25th percentile around 12 months. There are also tons of studies
on supplementing before 4-6 months. Check Medline. The Darling study
can be found in Pediatrics 1992;89:1035-41.
- Charlotte Baici
The fat content of breastmilk increases as each feed progresses, the
hind-milk being much higher in fat than the rest. Alternate breasts
at each feed, rather than letting her suckle one then the other each
time.
- Dave
Solids actually reduce the total calorie intake. Has she been getting
solids, especially low-calorie fillers? If she is in her first few months
and dropping, I would want your breastfeeding pattern and baby's latch
examined. Some babies are not put to breast often enough. In one study,
two extra feeds per day meant an extra 62% weight gain. Sometimes a
baby with a latch problem, sucking weakness or disorganization can coast
on mom's initial bounty squirting out on its own. As mom's supply gets
established, baby's poor suck may not keep it up. For instance, some
babies whose tongues are tied too closely to the bottom of their mouths
cannot fully empty a breast. Is baby lean, but healthy and happy? Sometimes
we find that mom or dad were thin, slow-gaining babies. Maybe grandmas
can offer reassurance. Let's discover if there is a problem, not pour
artificial milk over it.
Finally, some cardiac, metabolic and other disorders reveal themselves
in the weight pattern. If doctor is "fixing" breastfeeding
with formula and isn't looking at the baby's health, I might ask for
a better doctor. If baby has a health problem, the extra strain of bottle
feeding and the loss of human milk's benefits might pose a serious risk.
- Pan Easterday
Research has shown that the fat content in human milk varies, being
lowest in the morning and highest in the afternoon (Myles 1999). The
breast produces different types of milk and the fat content increases
during the course of the feed, sometimes 5 times its initial value.
The key is to make sure you exhaust one breast before you start on the
next. This way baby will receive the fat enriched hind-milk.
- Helen Oates
Shrops UK
In response to an inquiry about a link between using Pitocin and
autism:
In a September issue of Newsweek, the cover article was about the dramatic
recent increase in autism. Within that article, it briefly mentioned
one doctor who noted that 60% of his autistic clients had mothers to
whom Pitocin was given during labor. There was no study cited, just
an observation.
- Annie, aspiring midwife, perinatal nurse, CBE
I have a one-page article from the May 13, 1996 issue of Newsweek about
the mystery of autism. The article makes this comment:
"The social phobia of autism may be linked to the brain chemical
oxytocin. This molecule, best known for inducing labor and lactation,
also promotes maternal and other bonds and so has come to be known as
the sociability molecule. When Hollander administered oxytocin to five
autistic patients, it made them four times more talkative and, according
to the patients, twice as 'happy.'"
A more controversial theory focuses on Pitocin, a hormone given to women
to speed up their labor. Pitocin is the man-made analogue of oxytocin.
"Most of the mothers of patients we see have had Pitocin-induced
labors," says Haollander. He suspects that Pitocin somehow messes
up the newborn's oxytocin system, producing the social phobias of autism.
This idea is very preliminary, but it's an improvement on the theory
hatched when autism was first identified 53 years ago. Then, scientists
blamed it on unloving mothers."
I find it interesting that autism was first identified 53 years ago.
How does that coincide with the introduction of Pitocin into obstetrics?
- Melissa Schuppe, ICCE
Lynchburg, VA
In response to an inquiry regarding low basal temperatures in [Issue
2:39]:
I too had low basal body temps. When in college they were normal. When
we had not conceived for more than a year I started keeping track. My
thyroid was also checked as I could not get any weight off no matter
what I did. My norm runs about 97.2 and the most increase that I see
is .01 or .02. I did conceive and carry just fine. I think that watching
your own patterns and knowing them is really important.
- Pam Martin, MS, DONA CD, CM, apprentice midwife
In response to an inquiry regarding perineal tears [Issue 2:40]:
I had first-degree tears with my first two 8-12 and 8-14 lb. boys,
giving birth in a semi-sitting position in water. Both times I tore
nowhere near my perineum, I actually tore on my inner labia. It was
slight and needed no stitches. I can still see the separation of skin
from the first tear, but since it healed (about 3 or 4 weeks after the
birth) I have felt no pain whatsoever. The second tear was also more
toward the inside, I can't quite remember where, and I've never felt
pain after that healed either. My midwife doesn't do episiotomies, and
I'm glad I stretched and tore only a little bit just where the skin
was weakest and not cut through perineal tissue and muscle!
As for my third 9 lb. boy, I squatted for that birth in a tub of warm
water and didn't tear at all even though he was my biggest baby. What
probably helped me greatly was the fact that I took Dr. Robert Bradley's
advice and didn't wear panties through my whole pregnancy. My bottom
got lots of air flow and helped condition the skin.
- Sharon Thornton, AAHCC
Chesterton, IN
There's plenty of literature out there! Try this for starters: McGuinness
M. Norr K. Nacion K. Comparison between different perineal outcomes
on tissue healing. Journal of Nurse-Midwifery, 36(3):192-8, 1991 May-Jun.
- Dave
Please tell me more about the possible correlation between the Vitamin
K shot and challenges with breastfeeding! Although I have never thought
about it before, I have seen this play out with my children who received
the shot as compared with my children who didn't.
- Sharon
Greetings from Fortaleza, Brazil! As you may know, in Brazil, a country
where midwifery does not exist as an established profession, the cesarian
section rate in most private hospitals is as high as 90%, whilst poor
women give birth in degrading conditions in the world's most crowded
hospitals.
What you may not know is that in the same country, a number of initiatives
have been created since the 1980s that attempt to recover human values
in childbirth, a movement known as the "humanization of childbirth."
On November 2, 3 and 4 midwives and others interested in maternity care
from all over the world will gather at the International Conference
on the Humanization of Childbirth to promote humanized childbirth.
Contact the Conference Secretariat at +55 85 246 4302/246 0232, by fax
at: +55 85 246 2697, email: childbirth@eventuall.com.br,
WWW at: www.humanization.org
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