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15 Crazy Ways Childbirth Differs From Culture To Culture

In recent decades, modern medicine has drastically changed the way childbirth is dealt with in many parts of the world. The risk of death was once a very real threat every time a woman gave birth, but this risk has been nearly eliminated in many first world countries. Additionally, pain management options such as epidurals are being used more than ever before. Over half of all American women choose to receive epidural anesthesia during childbirth.

The way the Western world approaches childbirth has changed drastically in the last century. While, at one point, nearly all women gave birth at home with the assistance of a midwife, currently, 99 percent of all babies born in the United States arrive in hospitals. The same is true of other modernized countries such as Japan, Korea and China. At the present time, rates of C-sections performed are at an all-time high in many countries, with C-sections making up approximately 34 percent of all deliveries in the United States.

In other parts of the world, traditional rituals and long-believed practices are still the norm when it comes to childbirth. The book Childbirth Across Cultures, edited by Helaine Selin and adapted by Pamela Kendall Stone, has delved deep into the various ways childbirth differs from one country to another. Read on to learn more about some of the most fascinating, awe-inducing and stomach-churning birthing practices from around the world covered in the book. Some are amazing, others are shocking, but one thing is certain: whatever form it takes, childbirth is an intense, beautiful and miraculous process.

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15 Nepal - Put In Dark Room 

Nineteen year-old Maheshwori Devi Bishwokarma is pregnant with her second child. Despite being three days past due, Maheshwori continues to work herding goats, scratching out a living in the Himalayan foothills of Nepal. Her husband, who lives and works in neighboring India, comes home once a year.

In some rural parts of Nepal, men still purchase their wives. Women in these traditional regions are often considered property, and, as a result, are rarely given a say when it comes to reproduction. It is often up to woman's husband and mother-in-law to decide how many children she will have, and when she will have them.

It is common for women in these regions to get permission from their mothers-in-law before leaving home for any reason. Due to this fact, is very uncommon for expecting Nepalese women in rural, out of the way villages to get prenatal care of any kind, and home births are the norm for these women.

During the labor and delivery process, women are put in a dark room in a squatting position. A birth attendant will regularly apply fundal pressure, which is done by massaging the upper part of the uterus. This technique has been known to tear anal muscles if not done correctly, and puts mothers-to-be in potential danger. Often, women are encouraged to push too early, and there are many documented cases in of women in Nepal bleeding to death because their placentas were not delivered correctly after a baby's birth. If a new mother survives her baby's delivery, she spends the next 11 days in a darkened room and is not allowed any contact with men during that time.

14 Indonesia - Must Bury Placenta

Bali, Indonesia: 9th November 2011. CNN Heroes Robin Lim helps a young Balinese women deliver a baby at her clinic she runs in Ubud Bali, Indonesia. (Photos by Palani Mohan/Reportage by Getty images) C 2011 Cable News Network. A time Warner Company. All Rights Reserved.

In the country of Indonesia, women's childbirth experiences differ greatly depending on whether they reside in a developed or rural area of the country. In big cities such as Bali and Jakarta, hospital births are the norm. However, outside of major metropolitan areas, health care centers are available, but not always close-by.

Additionally, the horrendous amount of traffic in the country's bigger cities often make it difficult for women in labor to arrive at hospitals in time to deliver their babies. Indonesian women who choose to give birth in a hospital are encouraged to head to their chosen birthing destination as soon as labor begins to ensure they make it on time.

After a baby's delivery, many Indonesian women bury their placentas in a detailed and sacred ceremony. It is believed by Hindus that placentas are "living" organs, and are important counterparts, almost like symbiotic siblings or "twins" to a newborn babies. In the ritual, the placenta is cleaned, placed in a container and buried in a special place outside of a family's home.

13 Korea - Not Allowed To Leave Home For 21 Days 

Koreans hold the belief that everything a pregnant woman does, sees and eats during pregancy will have a direct effect on her baby-to-be. Expecting women even go so far as to avoid eating breakable foods like cookies and crackers, and don't eat duck to protect their babies from being born with webbed feet.

When it comes to childbirth, medical assistance is the norm, with 96 percent of all Korean deliveries taking place in hospitals. It is common for female relatives to attend a laboring mother in the delivery room while the father-to-be and other male relatives wait outside. The Korean culture discourages women from expressing pain during labor and delivery. In place of pain medication, acupressure, music and aromatherapy are used to help women through the process of bringing a baby into the world.

Episiotomies are the norm, and most women are not given a choice when it comes to whether or not they will get one. Korean women also have a period after the delivery of a baby when they are not allowed to leave their homes. The period, known as San-ho-jori, usually lasts approximately 21 days.

12 Sweden - Opt For Labor Lounges 

Sweden was recently ranked by Save the Children as the third best place to be a mother behind Iceland and Norway. It also has one of the highest rates of breastfeeding mothers and one of the lowest rates of infant mortality. Prenatal care is free for all women regardless of their income or social status.

Most women in Sweden opt to have their babies in hospitals, but the birthing facilities are comfortable and inviting. They include “labor lounges” where laboring women can congregate to snack, chat or watch television. Midwives oversee the majority of births, with doctors only intervening in emergency scenarios.

Medication is discouraged and looked down upon in some Scandinavian countries, but in Sweden, the choice of whether or not to use pain medication during a baby's delivery is completely up to the mother. Women are educated about risks and possible side effects of various interventions, and are then free to decide which option will work best for them.

11 Bangladesh - Cut Open Without Consent 

In Bangladesh, most women prefer to stay as far away from hospitals as they possibly can when giving birth. Not only do women lack the financial means to get to and from the hospital, they cannot afford the expensive medical bills that come along with a medically assisted birth. Additionally, women who give birth in hospitals in Bangladesh may be cut open without their consent and are rarely communicated with about what is happening to them.

Due to these factors, home births are still the norm in Bangladesh, with approximately 85 of all births occurring outside of medical facilities. Those who choose to stay at home while giving birth are usually surrounded by female relatives and friends during the labor and delivery process.

During labor, women are encouraged to harness their moner shahosh (mental strength) and shoriler shakit (physical strength). Expressing pain or discomfort during childbirth is discouraged. Bangladeshi women often move around, walk and hold on to poles or ropes during labor, and those who are Muslim often recite passages from the Koran to help them through the arduous process of bringing new life into the world.

10 Tibet - Cut Umbilical Cords Themselves With Dirty Knives

Tibetan women who have just given birth are viewed as dirty, and labor and delivery is considered an unclean event. As a result, women in Tibet often give birth to their babies alone in animal pens, and cut umbilical cords themselves with dirty knives after delivery. Not only are hospital births rare in this country, they are often not even a possibility due to lack of transportation and money.

The mortality rate in Tibet is sobering, with approximately 20 to 30 percent of all children in the country not surviving past their first twelve months of life. This is most likely due to the lack of emergency medical services and trained birth attendants in the country.

After a baby is born, and before he nurses for the first time, he is offered a paste that consists of butter, honey, saffron, water and musk water. It is believed that this concoction will protect a new child from evil spirits. The baby is then named by a prominent religious figure from the area where the child is born.

9 The Netherlands - Midwives Only 

Women in the Netherlands are mostly treated by local midwives, and only see obstetricians in emergency or high-risk situations. They choose whether they would like to deliver at a hospital or at home, and many women opt to have their babies in the comfort of their own homes.

Even women who have a chosen to have a hospital birth will be visited at home by a midwife when labor begins, and advised about when to go to the hospital. Epidurals are not common in Holland, and are usually only available if they work with an anesthesiologist’s schedule. In fact, some joke about “the Dutch 9-to-5” epidural.

Lara Schalken, an American woman who gave birth in The Netherlands, wrote of her experience, “If a mother gives birth early in the day without complications, she and the baby may go home in as little as two hours. Then the unique Dutch system of kraamhulp (maternity home care) is set into motion. For seven days we had a nurse come to our home, a benefit covered by insurance. Not only did she provide medical care, but she also cleaned our apartment, cooked, and instructed us in basic parenting skills. Another important duty of the nurse is to manage the flow of visitors and make the traditional snack to celebrate a birth: beschuit met muisjes, which literally translates as ‘biscuits with mice.’ The ‘mice’ are actually miniature licorice bits with blue-and-white coating for boys, pink-and-white for girls.”

8 Turkey

According to Tulin Sevil, a woman from Turkey's capital city, Ankara, the country has adapted it's approach to childbirth in recent years. Just a few decades ago, midwives were the main overseers of births in the nation. Doctors were only available in the most populated areas of Turkey which included Ankara and Istanbul.

With the founding of more university medical schools, and an increase in the country's doctors, more and more women are choosing to see ob-gyns over midwives. Elective C-sections are also becoming more and more common in Turkey. In fact, a recent survey conducted by Kybele, an American non-profit group founded to help promote safe childbirth practices in underdeveloped countries, determined that as many as 75 percent of all deliveries in private Turkey hospitals were C-sections. Epidurals are rare in Turkey. Because of this, many women choose to have an elective C-section because they know they are guaranteed to receive general anesthetic.

According to Ahu Terzi, a woman who emigrated to the United States from Turkey, both mom and baby stay home for 20 days after delivery. It is tradition for friends and family to bring a new mother a traditional beverage known as lohusa serbeti. It is also common for flour to be rubbed on a new baby's eyebrows and hairline; it is believed that doing so will grant him a long life.

7 Japan - Fathers Not Allowed 

It is common for Japanese women to attempt to give birth without any sort of pain medication. Ai Azuma from Tokyo explained that the reason behind this decision has to do with Buddist beliefs about suffering. According to Azuma, the pains of labor are considered to be something a woman must endure in order to help her prepare for the difficult journey of motherhood that lies ahead of her.

Most Japanese women give birth in hospitals, but the tradition of fathers not being present for a baby's delivery is still the norm. If a dad-to-be has taken prenatal classes before a baby's birth, he is allowed to present, but if a C-section is needed, he is expected to go to the waiting room.

Women in Japan stay in the hospital for 5 days on average after delivery of a baby, and the stay is more like 10 days after a C-section. Japanese women usually stay in bed for 21 days following delivery. It is common for friends and family to visit new mothers and enjoy osekihan (red rice and beans) in celebration of the baby's arrival.

6 Uganda - No Medication Whatsoever

In Uganda, approximately 60 percent of women give birth outside of hospitals. Medically assisted births are on the rise in the country, but are far from the norm. Ugandans refer to childbirth as Lutala Lwabakyala, which is translated to mean “women’s battle.” When it comes to having children, pain is expected. It is believed that women should battle the pain experienced during childbirth, and win. Many in Uganda view giving birth as a way for a woman to prove herself. It is considered a test of her endurance and strength.

Ugandans do not offer sympathy to women during their pregnancies, or their labors and deliveries. It is expected that moms-to-be remain composed and stoic throughout the entire process. Fear is viewed as a sign of weakness, and women who can’t cope with the pains of pregnancy or labor and delivery are looked down upon.

If a woman is able to give birth alone without medication of any kind, she is given the highest honor. Women who undergo C-sections are viewed as failures, and if a woman dies during childbirth, the community believes it is her fault and due to her weakness. At the present time, 310 out of every 100,000 births in Uganda result in the death of the mother.

5 Pakistan - Complications Almost Always Fatal 

According to Doctors Without Borders, "In Pakistan, one woman dies nearly every hour from complications during birth, and in Balochistan, the country’s largest and least-populated province, the rate is even higher. Here, one-third of women marry before the age of 15, and two-thirds are illiterate. Only three out of ten pregnant women deliver their babies with skilled attendants, meaning any complications can be fatal."

Clinics funded by the government are not affordable to most Pakistani citizens, and, in rural areas, mothers-to-be are lucky if they have a nurse or paramedic available to assist them.

The political instability in the region is yet another factor contributing to Pakistan's staggering maternal mortality rate, as is the lack of proper nutrition for many. It is not uncommon for Pakistani women to be underweight when they become pregnant. After a baby arrives, many Islamic republics, including Pakistan, participate in a baby-naming tradition known as aquiqah in which an infant's head is shaved and an animal sacrifice is made in honor of him or her.

4 Brazil - Encouraged C-Sections 

In Brazil, elective C-sections are becoming more and more common. According to the International Cesarean Awareness Network, the South American country's overall C-section rate is currently round 40 percent. In private hospitals, the rate is even higher. It is believed that Brazilian doctors often encourage C-sections in order to get higher payouts from insurance companies. These procedures are also a convenient way to increase the number of babies delivered each day.

In 1998, the Brazilian government set out to reduce the number of overall C-sections performed in the country. Their goal was to lower the C-section rate to 25 percent or less by 2007. The country has since seen a reduction in the number of C-sections, but it is believed that in private hospitals, the rate of C-sections being performed is still much too high.

In Brazil, pregnant women are akin to royalty. They don't have to wait in line, and are celebrated and revered by everyone in the community. After a baby is born, friends and family members bring gifts to the new mother and baby, and usually receive something in return. It is common for a bottle of perfume or some sort of candy, along with a message from the baby, to be given to visitors as a thank you for their support and love.

3 Nigeria - Kneel On A Stool 

Safiya*, 25, gave birth to premature quatriplets, but only two survived, Federal medical Centre, Katsina, Nigeria. One of her babies is in an incubator and the other one has been stabilised. Safiya has started holding her baby against her chest so she has contact with her and can breastfeed him. This method, called Kangaroo Mother Care Programme, was introduced in this hospital by a group of personnel that have been trained by Save the Children. This technique is an alternative to incubator because the mother’s body heat keeps them warm improving the survival rate of underweight newborns, but it also allows good contact between mother and child. (*not her real name)

For Nigerian women, the statistics are grim. Approximately 1 in every 18 women in Nigeria will not survive childbirth. Home births are still common in the country, with 58 percent of all women giving birth at home and 85 percent of women in rural areas bringing babies into the world outside of a medical facility.

In most cases, as is traditional in the region, women who give birth at home endure labor and a baby's delivery alone. They are often given a birthing stool to kneel on. Traditionally, it is believed that lying on one's back during labor is bad luck and causes good spirits to float away.

Only after a baby arrives, a birth attendant assists the mother in cutting the cord, cleaning things up and burying the placenta. It is common for new mothers to be cleansed with bunches of  boiled leaves and fed a concoction of spices to increase milk production.

2 China - Baby Taken Care Of By Others 

To go with "China-society-health-childbirth-lifestyle,FEATURE" by Tom Hancock This picture taken on November 28, 2012 shows a mother looking at her baby as she lies on a bed in a maternity ward at Antai Hospital in Beijing. The proportion of Chinese mothers choosing caesareans more than doubled in less than a decade, from around 20 percent in 2001 to above 46 percent in 2008 -- and approaching two-thirds in cities, according to the latest World Health Organization figures for the country. AFP PHOTO / WANG ZHAO (Photo credit should read WANG ZHAO/AFP/Getty Images)

Childbirth traditions in China vary greatly based on a woman’s social class. While the poorest mothers-to-be in rural villages still give birth at home without medical assistance, nearly all middle class women give birth in state-run hospitals, and the wealthiest Chinese women have their babies in top-of-the-line private hospitals where the C-section rate has soared to nearly 90 percent of all deliveries.

The birthing centers in many large towns in the country are run by zhuchanshi, or midwives. They do everything from abortions to C-sections. In these locations, the C-section rate is approximately 40 percent.

Whatever a woman’s status, and despite the westernization of the country’s birthing practices, after giving birth, nearly all Chinese women participate in a tradition known as zuoyuezi, translated to mean “to sit the month.” New mothers spend the first month after giving birth in bed while household duties and all care of their child other than breastfeeding are taken care of by family members or hired nurses. They are not allowed to get wet, which means avoiding showering and, in some cases, the brushing of one’s teeth. New mothers are also denied raw vegetables and cold drinks and are not allowed outside.

1 Germany - Three Years Of Unpaid Leave 

Midwives are well-respected in Germany, and, as in Holland, women usually only see doctors in cases of high-risk pregnancies. Many in Germany view having a C-section, or getting any sort of pain medication as a failure.

Mothers in Germany who have full-time employment are given a mandatory 6 paid weeks off before their due dates, and at least 8 weeks of paid leave after delivery. They are also able to take up to three years of unpaid leave without losing their employment.

Schalken, who has done extensive research on varying childbirth customs from around the world, mused,"Women in the U.S. know they are fortunate to have access to arguably the best medical care in the world. After my very positive birthing experience in the Netherlands and hearing stories of other people's births, I realize we Americans have much to learn, as well as much to be thankful for. Now that we've moved from Holland back to Texas, I'm wondering how I'm ever going to survive the next time without my kraamhulp nurse!"

Sources: Parenting.com, Parents.com, HuffingtonPost.com, DoctorsWithoutBorders.org

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