The rich cultural traditions of American Indians make for some unique pregnancy and labor experiences. From herbal remedies for slow labor, to intricate naming ceremonies, to celebrations held in honor of the baby's first laugh, there's beauty to be found in each of these culture's motherhood traditions. Some of these fascinating traditions are still practiced today, like the creation of hand-woven cradle-boards that carry the precious cargo through his or her first few months of life. We've even found one remarkable story of an Anishinabae woman's labor that could've gone terribly wrong, if not for the loud support of her family.
On the other hand, American Indian women face some tough challenges during pregnancy and childbirth that other American women would be shocked to discover. American Indians and Native Alaskans alike face higher rates of virtually all pregnancy complications and often have problems accessing any prenatal care, nevermind care that is culturally appropriate or considerate of the pregnant woman's own choices. We'll detail some of the best efforts to remedy these problems, from recommendations from researchers to focus on Indigenous knowledge-based care, to one pioneering midwife who plans to open the first Aboriginal Pregnancy Center in the United States. First, let's start at the beginning, with the historical experiences of pregnant indigenous women.
The descriptions we have from male colonizers in the seventeenth century speak of Indigenous woman who left their communities to give birth alone, painlessly, and with quick recovery. Historian Ellen Holmes Pearson, PhD and professor at the University of North Carolina, warns that such depictions are likely inaccurate. As foreign men these colonizers would have little understanding of Indigenous culture and were unlikely to know much about childbirth in general. Instead, Pearson argues that most indigenous cultures were likely to allow mothers and select community members to witness and aid in childbirth. However, Pearson does lend more stock to the nineteenth century recordings of James Mooney, an anthropologist among the Cherokee who describes an Indigenous practice where a grandmother or aunt would tell a frightening story to scare an infant out of the mother's womb. We've all experienced that end-of-pregnancy desperation for labor, perhaps next time we'll read some Stephen King to help the process along!
Without any hormones to induce labor, indigenous cultures invented all kinds of techniques to start labor and to encourage along women whose labor was failing to progress. A variety of herbal teas were brewed and provided, depending on one's culture and which plants were available in the area. Walnut, wild cherry, raspberry leaf, horse-mint, rosehip, wild carrot, and sumac are among the dozens of plants used for every kind of pregnancy-related purpose. Of course, some of these have been found to have adverse effects or to be generally ineffective, and we'd caution you not to use these plants unless you talk to your doctor about it (others are effective and safe). Conversely, there were many superstitions about what not to do during labor. For example, some believed that lingering in a doorway would cause your infant to linger in your doorway. Once labor was safely underway, women would sit, squat, or stand to deliver, as it was thought that laying down would prevent the child from ever coming out! When the baby did appear some cultures didn't catch the child, letting it fall onto a pile of leaves beneath the mother instead. This is now thought to be akin to the practice of spanking the baby, a bit of rough treatment to get the child's lungs working.
The Cherokee culture has some interesting and ancient traditions surrounding pregnancy. Pregnant women are not allowed to eat pheasant, because pheasants loose most of their babies and it was feared that the pregnant woman would therefore loose her baby if she ate of the bird. Pregnant women were also forbidden to enter a stream when the community was fishing in it. The Cherokee fishing technique was to pound walnut bark and then throw it into the river to slow or confuse the fish. It was believed that a pregnant women who entered the river would prevent the bark from taking effect unless she had thought ahead and had tied some of the bark to her toe first. James Mooney, in his book "Myths of the Cherokee", explains that pregnant women, like menstruating women, were believed to be powerful and uncanny. In particular, their touch was a conduit of power, for good and ill, which is why menstruating women spent their time in isolated huts.
One Aboriginal community, the Hopi, have an ancient purification ritual for the newborn baby and their mother, that is highly complex and connected to their creation legend. After the child is born they are kept in their home in darkness for twenty days. The mother chooses the perfect corn (that has four kernels on the end) to symbolize their Corn Mother (their creation goddess) and places it beside her child. For nineteen days the child is bathed in cedar water (like a cedar tea) and rubbed with ashes in a specific alternating pattern. The mother is also occasionally washed and drinks the cedar water. As the days go by the family draws lines in corn meal on the home's wall, then erases the lines in steps and redraws them in the community temple. These lines are the baby's spiritual home and their movement indicates that his spiritual home, once the mother's womb, is becoming the community temple. This is the baby's introduction to their spiritual life.
At the end of this long ceremonial process the Hopi baby is ready to be named. On the nineteenth night the baby's aunts arrive with corn and they and the mother bless the baby. Each aunt gives the child a different name and they each wish it a healthy life. The mother and grandmother leave the house at dawn with the baby and as it first sees the sun the mother introduces the baby to their Father Sun, the Hopi's second creation figure. The mother and grandmother's primary wish for the baby is that they follow the Mother Corn and Father Sun's rules, so that he or she can grow to be old and wise. Then the mother and grandmother draw out a cornmeal path towards the sun, to indicate the child's religious path in life. Over the first few years the baby is called by each name the aunts gave them, until one name sticks. The lucky aunt that chose that name gets to be the child's godmother!
Nurse and Midwife Ursula M. Knoki-Wilson seeks to include Navajo traditional practices into her contemporary midwife care. She has a guide for other health care practitioners where she outlines the kinds of care and traditional practices a contemporary Navajo woman may expect and adhere to. Navajo women traditionally try to create a time of peace around their pregnancy. They try not to argue with their partners or speak harshly, especially not to children. Instead they try to maintain positive thoughts and double their efforts to do a dawn prayer daily. They are also supposed to avoid looking at anything dead, which means they are not supposed to attend funerals or butcher animals. Neither are they supposed to be around sick people, which makes good sense to anyone! Various ceremonies are performed by the expectant mother and her community, especially one called "Blessing Way" which encourages safe delivery of the baby.
Once a Navajo woman's water has broken she is encouraged to seek out a medicine person to sing their traditional "Singing Out Baby" chant. While much of the pregnancy is community focused Knoki-Wilson warns against having too many people in the delivery room. Just the helpers is best. The helpers will prepare herbal tea for the mother and burn cedar and/or sweet-grass nearby. During the actual pushing phase of labor the mother is encouraged to take a squatting position, while holding onto a birthing sash that has been created for this exact purpose. After the baby is born the umbilical cord is to be buried in a special location (maybe near a sheep's pen or a loom). The woman is to wear the labor lash around her waist for four days afterward, which would certainly make us feel strong and proud! Less appealing is the Navajo perspective on the baby's diapering needs. Traditionally, the Navajo women tried not to insult or worry their baby by showing distress if the child soiled them. Some traditions call for the woman to go as far as smearing the baby's first stool on their face!
There are several beautiful traditions that Navajo women might choose to follow with their newborn. Soon after the birth the baby might be given corn pollen tea or juniper tea, along with breast-milk, to cleanse the baby. Navajo tradition is very concerned about the baby's soft spot. No one is to cover the soft spot with their fingers or put a bowl or basket on the baby's head, which makes good sense to contemporary medicine as well. When the baby first laughs the Navajo hold a "First Laugh" ceremony to celebrate. Navajo tradition does not allow for the baby's hair to be cut until they say their first word. Like many other aboriginal cultures in North America the Navajo also create a cradle-board. This is a cross between a baby carrier and a bassinet. It's meant to provide protective transport and sleeping space for the baby's first few months of life. The Navajo traditionally craft the cradle-board out of Ponderosa pine, leather straps to hold the child in, and padding of cloth or plant fibers.
While no one is sure precisely why some infants suffer Sudden Infant Death Syndrome (SIDS), it is clear that aboriginals in the United States are twice as likely to die of SIDS than the general population and three times as likely as white Americans to die of SIDS. This challenge facing Native Americans has been greatly reduced since the 1990s when the SIDS rate was double what it is now! In 1992 the "Back to Sleep Campaign" began which educated Native American mothers about what kind of sleeping habits might contribute to their child's SIDS risk. While some aboriginal cultures call for co-sleeping, side-sleeping, and wrapping the baby in soft materials, these are contributing factors in SIDS. Aboriginal women have by and large changed their baby's sleeping conditions, but further work needs to be done to help reduce their children's risk of SIDS.
American Aboriginals suffer from higher rates of all kinds of pregnancy complications. Disturbingly, eclampsia rates are twice as high among aboriginal mothers and postpartum hemorrhaging is four times as high. Also, gestational diabetes rates are three times higher among Aboriginal women than among the general population. These health factors aren't due to age factors among these mothers either, as teen pregnancy rates in Aboriginal communities are either on par with national average or well above. In California the Aboriginal rate is about 24 teen pregnancies per 1000 pregnancies, as compared to the national average of 34 teen pregnancies. On the other hand, near Nebraska and the Dakotas the Aboriginal teen pregnancy rate is 123 teen pregnancies per 1000. The CDC was begun a program called "Native Women Wellness Initiative: Working Together to Improve Health Outcomes" to address these higher rates of disease.
The CDC has identified several contributing factors to American Indian's higher rates of pregnancy complications and disease. They've cited poverty, access to education, and unemployment as general factors that limit all American Indian's access to healthcare and grow the burden of disease on their communities. Of course, these same factors trouble pregnant women. Independent of the CDC, researchers conducted a study on prenatal care in American Indian communities and found other factors that negatively effect pregnant women and their offspring. Largely, the study found that the death of elder women and federal assimilation have prevented the transmission of knowledge and support from one generation of mothers to the next. American Indian pregnancies also face high rates of domestic abuse, substance abuse, and tobacco smoking, all of which negatively effect the mother and child's health. Additionally, the study found that the prenatal health care model in the United States discomforts many Aboriginal women. Many Aboriginal women feel that most doctors discourage even the mother's healthy cultural practices and is difficult to access from their communities.
These researchers' proposed solution to this problem is to re-frame prenatal care for Aboriginal women, centering their cultural practices and knowledge which can then work in tandem with current medical techniques. Key to this process, according to these researchers, is to allow for Aboriginal elders, grandmothers, and midwives to attend to pregnant women and provide the majority of the prenatal care. In this model, a pregnant Aboriginal woman would hopefully regain access to her cultural traditions surrounding birth and feel the support of her community in planning for a healthy and safe pregnancy. As we saw earlier with the contemporary Najavo labor, some hospitals are equipped to include cultural practices into the delivery room, such as the inclusion of the Najavo birthing sash above the hospital bed. Further inroads in hospitals could be made if pregnant women were allowed to adopt their cultural birthing positions like squatting (which plenty of non-Aboriginal women prefer as well). However, hospital cultural-sensitivity is not the only option for aiding Aboriginal pregnancies, midwife Nicole Gonzales has another idea.
In 2015 midwife Nicole Gonzales began planning for the first Native American Birthing Center in the United States, to be built in New Mexico. While some Navajo women have felt unable to incorporate their cultural birthing practices into hospitals (or were denied permission to incorporate these practices), Gonzales wants to change this through the Birth Center. Gonzales told the Huffington Post, "At the birth center, you won’t have to ask anybody for permission". Instead, Gonzales intends to ask women about their traditions and allow them to easily incorporate them. For example: drumming, burning sage, and having multiple attendants are not always allowed in hospital rooms. Gonzales also told Indian Country Today that many Aboriginal women don't realize they have choices in their pregnancy and arrive to hospitals or medical care without a plan. To remedy this she hopes to provide early consultation at her birthing center, where she can discuss the to-be mother's options and wishes for her pregnancy and labor experience. You can donate to Gonzales' cause here.
In Canada and the United States remote Aboriginal communities may have difficulty accessing medical care during their pregnancy and labor. One Cree community in Manitoba is eight hours away from the closest major hospital (in Winnipeg). Therefore, women who were getting close to their due date were instructed to travel to Winnipeg early and stay in their community's band house in the city, along with sick people who were getting treatment in the hospital. Family members usually can't stay with the expecting mother in Winnipeg and so family will often miss the whole birth as a result. Child birth is a hard enough process to go through with support, never mind alone in a faraway city! Luckily for this Cree community, a Metis midwife Darlene Birch has made the community her home. She now provides birthing support for about half of the community's births (which number 150-200 babies a year) in their homes or in the closer local hospital. Sometimes women who choose to remain in the community have to avoid seeing the local doctors though, to avoid being forced to leave via emergency medical transport ordered by the doctors.
Kerry Bebee, an Anishinabae midwife, remembers fondly one birth experience of her Anishinabae client's. The expectant mother had a long labor in her home and grew tired during the pushing phase of labor. The midwife began to worry that if the mother was not successful soon she would need to be brought to the hospital, or they risked endangering the baby and mother's life. Equally worried, the expectant mother' sister went into the next room, where the woman's family waited, and began to drum and sing. The whole extended family picked up the song to encourage the mother. They could soon be heard from the delivery room, singing to their creator to help the baby. The midwife could see that the mother was visibly re-energized when she heard the song and began her pushes with new strength. The baby was born during the second song, amidst the loud support and drumming from his nearby family.
Sources: Aboriginal Midwives.ca, American Indian Healing Arts, CBC.ca, HuffingtonPost.com, IndianCountryTodayMediaNetwork.com, James Mooney "Myths of the Cherokee", FirstPeople.us, CDC.gov, Ncbi.nlm.nih.gov, TeachingHistory.org