Whose Educating Who?

This week I went to a study day about cultural awareness in midwifery care. It was a great day with speakers about African, Aboriginal and Muslim culture. The thing that really struck me is that there is a story beyond and above the person that you see in front of you.  In our western way of doing things, in particular here in Perth where we do live in a very wealthy, high tech society, the drive to ‘tick all the boxes’ is very strong – fear of litigation, pressure of time and busyness can all cloud that broader perspective. A woman who is pregnant needs time – she needs time to develop trust in her caregivers, to open up when she feels safe and secure, she needs time to come to terms with all the changes that are happening in her body and will happen in her family. Ultimately she needs to be able to do all those things in her own time.

It was so refreshing to hear about the great work the Moort boodjari mia service is providing for Aboriginal women in Perth http://www.healthinfonet.ecu.edu.au/key-resources/programs-projects?pid=936 and also the Ishar Multicultural Womens Health Centre in Mirrabooka http://www.ishar.org.au who really aim to provide care that meets the needs of the women they serve, rather than the other way round, forcing them to fit in with the bureaucracy that develops in large corporate health settings.

Pregnancy and birth is such a profound event in a woman’s life. The experience has many influences – culture, tradition, family, religion, superstitions, environment, health, carers… I may be wrong, but what I hear and what I see is that over and over again in western culture we take the moral high ground, stating that our way is the best way.

A very experienced midwife who has spent many decades working in the developing world said to me, “Don’t assume that the women don’t know anything about pregnancy and birth”. Wow! That is a profound statement and one that deserves thought. Just because the maternal and infant mortality rates are high in Papua New Guinea and they don’t have access to all the machines that go ‘bing’, doesn’t mean that they know nothing about birth. Reading some more thoughts from Robyn, I’ve learned that you can give all the education you like and it can all be based on science and fact, but ultimately the woman will seek out the advice of a trusted and respected village elder. Forming a good relationship with the respected village women is an important strategy; listening to what they tell of womens’ experience of pregnancy and birth in their village, then very gently show them good practise (act it out in a role play preferably) so that when next a woman comes to her for advice, she will remember the role play and be able to direct the woman into safe health care practises. If that advice is positive for the pregnant woman and has a good outcome, they will start to trust the advice the “Australian woman” gave and be more likely to follow that regime of care.

I had better start preparing for some Oscar performances in Yamen!! Oh, have I told you that the destination has changed again? Now we’re going to the village of Yamen, still along the Keram River, but in an area that will allow many more people to come for support and care. Although, I’m starting to feel that it will be me that will be getting the education…

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