Bulletin

Issue: September 2005

News

Birth - When it's no longer a natural event

It once was considered the most natural event in the world - the birth of a baby.

But to many women today, even some living in poor rural areas of Thailand, birth has become an event to be managed using technological interventions.

'Despite this, some things never change,' says Dr Pranee Liamputtong, an Associate Professor in La Trobe University's Department of Public Health. 'The most important never-changing aspect is the huge need for the new mother to have close support and assistance in the month after birth: the "postpartum" period.'

Dr Liamputtong spent a total of 12 months in and around the northern Thai city of Chiang Mai, six months in 1999 and six months in 2003, working with 30 Thai mothers or mothers-to-be recording their most intimate feelings before and after the birth of their babies.

In 1999 she visited all women in their homes, many before their babies were born to ascertain their ideas on birth and what they expected child raising to mean.

On her return in 2003 she again interviewed the women to monitor their progress and establish whether their views had changed.

Half were middle class urban women and the other half of peasant background who lived in conditions considered primitive by western standards. Despite lower levels of housing standards and education, many of the poorer women still had access to modern medical care.

Despite this access, most women in the lower socio-economic group still clung to traditional beliefs and practices during the postpartum period, much more so than urban middle class women whose greater dependence of doctors tended to make them dismissive of such practices.

According to Dr Liamputtong, this gives peasant women considerable advantage over urban middle class women.

She believes that postpartum care incorporating local traditions means peasant women optimise their health when they are at the most vulnerable stage of their lives. She believes such practices should be maintained.

'A woman who has just given birth is vulnerable to dangers and illnesses due to her physical and emotional weakness caused by the act of giving birth. In some circumstances she is also capable of causing danger to others due to her perceived polluted nature of childbirth and its blood,' Dr Liamputtong said.

'Traditional birthing rites of passage are an attempt to safeguard the new mother. She is taken care of by her close female kin where she has no contact with outsiders and her diet and behaviour are monitored.

'In this part of Thailand, these rites help new mothers to cope with the demands of motherhood, making them see motherhood as a positive aspect of their lives, in contrast to the viewpoint of many women in Western societies who may regard it as oppressive.'

Dr Liamputtong says her experience with the project in northern Thailand makes her believe that models of mothering need to take into account ethnicity, 'race' and differing family forms as women come to motherhood by a variety of different routes in different circumstances.

'I believe that these differences must be recognised so that a clearer understanding of motherhood can be achieved. Only then can health services and care be made more meaningful to new mothers.'