Giving Birth Across Cultures

Those of you who have spent any amount of time talking to me know that I love birth.  I’ve read and re-read scores of books on natural childbirth, and with the help of my dear husband, have experienced 4.  So I know all about birth.  In America.  I am very much a baby regarding Cambodian-style birth.  I’ve learned a few things about it so far – from our neighbors, from my mother-in-law, and from my teammate Casey.

During language training I learned that the same word construction for giving birth is used for catching a disease. I had to laugh because in my doula training in America we hear over and over again that pregnancy is not a disease. I don’t know yet if this peculiar naming practice indicates anything about the culture’s beliefs regarding health and wellness in childbearing.

I see a lot of malnutrition here.  At our first wedding I noticed a member of the couple’s family who had no teeth and a fairly large goiter (from lack of iodine). I see children whose naturally dark hair has turned red or blonde, a sign of the protein deficiency of kwashiorkor.  There are children whose limbs have wasted away and whose tummies are swollen from marasmus, which is deficiency of both calories and protein. People’s teeth are black or missing. We don’t see this kind of major malnutrition in America.  Most of us enjoy a great deal of good health.

But a mom’s health affects the health of her baby, and breastfeeding, which should be the best form of nutrition for babies, is not extremely common.  Even moms who nurse their babies sometimes feed formula the first few days, depriving their babies of the immune-boosting benefits of colostrum.  Some claim that moms don’t produce enough milk as a result of their malnutrition.  Formula is affordable by the middle class, but not by the poor.  Instead poor moms feed their babies watered-down sweetened condensed milk.

You would think in a developing nation women have no access to pain relief in childbirth.  And if you’re thinking pain relief = the epidural, then you’d be right.  But here it’s shameful to show pain, so women are heavily drugged with narcotics during labor. One woman I met was told she wasn’t pushing well during labor, presumably because of narcotics, according to my teammate.  (To all my doula readers:  This is where the rope or towel pull would come in handy over here.)  Husbands aren’t present at birth so it’s a purely feminine affair.

After birth mom and baby are wrapped tightly to keep warm and prevent aging. Mom especially isn’t allowed to get cold the first 3 months, so she must wear long sleeves.  The downside to this practice is that there is no skin to skin contact between mom and baby, which improves the health of both in early postpartum.  For those first 3 months, though, mom isn’t allowed to do any work – not even climb stairs.  She really and truly rests from the work of pregnancy and childbirth. Dad does the work.

I love the way life here is communal. Everyone lives in community, and the moms are no different.  Some moms go to the countryside to be with their family of origin during the postpartum. This admittedly inhibits initial daddy-baby bonding, but it illustrates the network of helpers available for mom and baby.  We don’t have this same community safety net for independent American women.  In fact, trying to explain to my language tutor what a doula does was quite difficult.  It wasn’t just a language barrier; it was a culture barrier.

Indeed, I came to Cambodia with a core set of values, from a culture I considered to be “normal, natural, right and good.”  But I don’t live in that culture anymore.  I live in a new one.  May this be my prayer:  Father, grant me the grace to see the people in this culture as eternal souls created in Your image.  Let me not judge them as “abnormal, unnatural, wrong, and bad.”  Let me see their culture from their point of view and not my own.  Let me see the good in their culture and remember not to dismiss it with the bad. And let me never see any person as unredeemable.

5 thoughts on “Giving Birth Across Cultures

  1. This was very interesting! Thanks so much for sharing. I gave birth to my daughter here, and I think I broke every postpartum rule they have here! But I do think it’s wonderful how they really do allow mothers to rest here.

  2. Great post…and I learned some new things (I didn’t realize that Khmer women are often drugged during labor etc.) We arrived back from furlough when my son was 1.5 months and my Khmer friends were horrified by my high levels of activity (trying to get the house back together after an extended leave etc.). Since the women do the majority of the hard work here, I think it’s a great blessing that they can have those 3 months off! It might even be a motivation to have more kids! Ha ha.

  3. Elizabeth,thank you for writing about the subject of health– it’s really been on my mind these last few weeks since moving to Cambodia. Sometimes it’s hard to know what to do with our ideas of what good health practices are (or nutrition or whatever) in a place that is so different!

  4. Elizabeth, Your writings are very wise and I am so proud of you! Thank you for sharing your thoughts. You are an excellent communicator and will help many with your loving words! and actions!

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