New Beginnings Doula Training

New Beginnings Doula Training
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Wednesday, April 13, 2011

Cultural competence

I have just started a course on cultural competence for nurses. It is a part of a research project being done, which I am excited to be a part of. I thought I'd use this site as a place to write down thoughts or ideas as they apply to myself, motherhood, and birth.

Just as I am reading the introduction of vocab and definitions, I am struck by the fact that we like to put people in certain categories or groups. I think it makes it easier on us to understand. But people are never as easy as that. So the dilemma comes from trying to use what we understand of culture, yet still treating others as individuals.

Also, culture goes beyond just race or color. The course I'm taking defines it as, "'a wide range of social behaviors, values, attitudes, and shared symbols that most people take for granted as part of the general background of their lives. Culture pervades the mundane and influences the extraordinary moments of human lives'(Schim et al., p. 104)."

I began thinking about how there are different birth cultures also. I had my first two children in a birthcenter that was very good at creating a birth environment to support physiological birth. When I moved, I could not find a place like that and I definitely felt like I was in a different culture.

Some of the things that I remember being different for me was all the machines and the routines of the hospital. Checking in was a shock, as was not having instant access to my care provider. In fact, I chose not to have my blood drawn. Because of that the nurses got mad at me, but I didn't understand why or their reasoning behind drawing my blood again when it had been done at the office(I didn't have to get this done a second time at the birth center). Their insistence of needing to have my baby continuously monitored baffled me also. They always did intermittent monitoring at the birthcenter. Induction was only mentioned when there was medical problems at the birth center, but in the hospital system they offered it too me quite a bit and I was confused as to why I would get an induction when nothing was wrong. I laugh at my confusion now, because I really did feel like a fish out of water.

Even thinking about this now, it might be useful to ask a woman what she expects from birth or how she sees her birth playing out. I wonder how many women feel like fish out of water like I did. I think we also need to take care to not assume that every woman is going to see birth the same way we do.

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Birth is a Journey: Does it have to be life changing?

  • One woman might have to climb on an overfilled boat, risking her life and nearly dying as she escapes over the ocean to come to this land. This experience could certainly be life altering. It may very well color the rest of her life, positively or negatively. (I overcame this amazing struggle and here I am triumphant! OR Holy crap, that was SO hard I don’t know if I can go on! By the way, neither response is “right”. No one would judge the woman with the 2nd response.)
  • One woman may buy an airplane ticket, sit on a comfortable 747 and fly to America with a nice smooth flight and landing. She is happy to be in America. Those welcoming her are glad she is here safe and sound. She may only travel by plane 2-4 times in her life, so it is pretty memorable. But the journey itself probably wouldn’t be life changing; it would simply be a journey.
  • One woman may learn to fly an ultra-light plane to lead a flock of geese into America teaching them to migrate. This experience could certainly be empowering and life altering.