Traditional Birthing Systems

Traditional Birthing Systems

Knowledge of birth is socially constructed. The biology of birth is molded by members of a society into rituals and practices that make sense to them. Thus we come to understand why certain aspects of birth are taboo while other practices are accepted, and why certain individuals are excluded from the inner circle of the birthing event. The social nature and significance of birth ensure that this biological and intensely personal process carries a heavy cultural overlay. In all cultures birth is a rite of passage that embodies a culture’s deepest beliefs, which are transmitted and reaffirmed during this critical transitional time. Birth practices point “as sharply as an arrowhead” to the core values of the culture, telling the observer a great deal about the way that culture views the world and women's place in it.

The cultural meanings of conception and birth, preparation for births, the support and the attendants, use of medication, locus of power and decision-making, and the physical boundary of birth have to be understood in a social context. Women have always given birth to the next generation. Those women who have birthed in rice paddies are no different from those who have birthed in taxis or unexpectedly at home. While the process of childbirth is, in some sense, everywhere the same, it is also everywhere different in that each culture has produced a birthing system that is strikingly dissimilar from the others. Multiple perceptions determine the management of birth as either a medical or non-medical event.

The more the issues of childbirth are being studied, the more people are realizing how multidimensional the experience of childbirth really is. Birth and labor include intense psychological, physiological, social, spiritual and emotional elements that contribute greatly to a woman's experience of that birth.

The process of birth provides a structure around which social and cultural forces guide its expression. These social and cultural forces reflect the organization of power in a society while creating the potential for diversity in birth beliefs, practices, and experiences. Birth is paradoxical: a very predictable yet unpredictable human passage. On one hand, almost without fail a vast majority of human females spontaneously begin labor, progress through increasingly intense stages of labor, feel like pushing, and give birth, at approximately 40 weeks after conception. On the other hand, reliably predicting birth in any greater detail than this is basically impossible. We cannot know the day or week labor will begin, how long it will last, exactly how it will feel, how we will react, or the health and sizes of our babies. What we can do, however, is to educate ourselves about the vast array of possibilities and learn which are more likely to occur. We can decide what is ideal and what we will strive for, what are the means to creating the most conducive environment for such a birth, and which people can best help us to attain those birth arrangements. Finally, we can prepare our own bodies and hearts for the process.

Even childbirth is affected by globalization--and in Ghana, as elsewhere, the trend is away from home births, assisted by midwives and traditional birth assistants, toward hospital births with increasing reliance on new technologies. In Ghana, as in many developing countries, women suffer poor reproductive health (nutritional deficiencies and infections) going into pregnancy and experience further complications and other disabilities during pregnancy, labor and delivery and in the postpartum period.

According to Martey et.al (1998) the health system in Ashanti Region as it operates in the rest of Ghana is made up of three sub-systems, namely, public, private and traditional. The public sub-system is made up of essentially what is referred to as orthodox medical services provided in government health facilities while the private sub-system refers to orthodox medical services provided in private (including missionary) hospitals, clinics, maternity homes, chemists shops who are all profit oriented. The traditional sub-system refers to medical services provided by herbalists, traditional healers, traditional birth attendants, spiritual healers and many others. For example, in Ashanti region of Ghana, the public sector provides 60% of health care followed by the traditional sector which provides 30% and the rest by the private sector (Martey et al, 1998).

The total population of Ghana in 2000 was 20.2 million. Currently, the country’s population is growing by 2.5 per cent per year. At the same time the total fertility rate has declined from 5.5 children per women in 1995 to 4.5 by 2000.

Over the same period of time (1993 to 2000) the infant mortality rate declined from 66 deaths per 1,000 live births to 56 deaths per 1,000 live births. The maternal mortality rate has been estimated at 214 per 100,000 live births. As a national average, 40 per cent of all births are now attended by a trained health professional.

Still, there is a distinct North-South divide in the country. The impoverished northern part of the country suffers from much higher rates of infant and maternal mortality, registers a total fertility rate nearly twice that of the nation as a whole and has fewer well equipped health facilities compared to the populous southern region. Maternal mortality in the north varies from 330 to 500 per 100,000 live births. Total fertility rates are close to 7 children per woman and only 9 per cent of all deliveries in the north take place in a health facility with trained personnel (compared to three-quarters in the Greater Accra region). Literacy rates in the north are only half the national average: 23 per cent compared to 48 per cent.

Prenatal Care

Pregnancy is not an illness. It is a natural process that, in most cases, does not present a risk to either mother or child. However, living as healthy a life as possible during pregnancy will benefit both mother and child when the time of birth arrives. Healthy eating will help your baby have a healthy birth weight. Exercise will keep get your muscles ready for labour - it's hard work to deliver a baby!

Traditionally, pregnant and nursing mothers led a healthy lifestyle with lots of physical activity and a nutritious diet. Keeping an active life was seen as essential to promoting quick labours and ensuring the placenta did not stick to the womb. Women were encouraged to eat a variety of foods.

Family Support

Traditionally, a large circle of family members supported the pregnant woman and were around to help and advise before, during and after birth. Today, family support is often harder to come by, with family members living in different places and family problems affecting the ability to care for one another. Community services can work to encourage and strengthen family ties, provide services in ways that welcome fathers and support their involvement in the birth process, and offer programs such as support groups and buddy systems to provide support to pregnant women and new mothers. The new mother and baby stay at home for 40 days (adaduanan) after birth, with female relatives and friends helping to care for them.

Breastfeeding

Breastfeeding brings many benefits to baby and mother. Breast milk is the best food a mother can give to her newborn child. It may not be easy at first, but most women can successfully breastfeed their children with the help and encouragement of their health care providers, family and friends.

The midwives teach the women about good nutrition, parenting after giving birth and breastfeeding. In many cases, they successfully encourage women to breastfeed even if their newborn babies are going to be adopted. When women learn the critical role of breastfeeding in developing the immune system, they are happy to breastfeed the babies. There are many traditional practices that can help Aboriginal women care for their newborn babies. Health care providers, midwives and the elder women teach the younger women what these traditions are, and why they benefit both mother and child.