Rebekah and Dr. William Olsen, Anthropology
Giving birth in Mampong, Ghana is a ritualized process of behavior involving not only the mother and her child, but also many different segments of society. Upon giving birth, a mother’s life will change considerably and her role in society will transform radically upon the safe delivery of her infant. She will become initiated into a new culture of motherhood and will have various decisions to make concerning the birth of her child. Throughout this project, I kept a double focus. First, I attempted to record some of the birthing options available to mothers in rural Ghana. Next, I also wanted to try to understand the significance of motherhood in Asante culture and how giving birth changes the status of a new mother.
Introduction
Physiologically, birthing is fundamentally similar throughout the world, yet it also has a highly religious and social component. Each culture has a distinct concept of the “right way” to bring a child into the world. The Asante Culture is no different in this respect. This society has a plethora of specific rituals that surround the birth process, many of which are practiced by rural midwives and have been practiced for centuries. Other practices are fairly new to Ghana and are practiced by Western-style physicians. One extremely important component of the birth process that I observed was the strong religious and spiritual component associated with the birth process. Whether giving birth in a hospital or under the care of a midwife, birth in Ghana is far from just a physiological process; birth is a religious and spiritual journey that can be wrought with hardships and triumph.
Birthing Options and Specific Practices
There are two primary birthing options available to women in the Asante culture. The newest option available is to give birth at the Mampong District Hospital, where the new mother will be attended by medical doctors and licensed midwives. Also, a woman may choose to patron one of the hundreds of lay midwives that live within the Asante region. This option will usually mean that the mother will labor at home. Of the 15 lay midwives I interviewed, about half had formal training courses in midwifery, usually offered by the hospital or local community health service. These midwives, all women, have been mostly trained by close friends or family and use techniques handed down through generations.
The hospital offers a mother the newest forms of medical technology currently available in Ghana. At the maternity hospital in Mampong, the hospital boasts the availability of incubators, surgical rooms, oxygen, and sterilization machines. However, the actual experience of pain during the birth process is not lessened significantly in comparison to homebirths. The use of epidurals are only used is absolutely necessary as in the case of a mandatory cesarean section. Some mothers may receive local anesthetics in the advent of an episiotomy or other minor surgical procedure.
Giving birth at home under the care of a midwife may reflect more traditional Ghanaian birth practices. Each midwife may use different techniques to ensure the safe delivery of a baby. However, most of the fifteen midwives interviewed will employ certain techniques to ensure basic sanitation. 13 of the 15 midwives used some form of “tying” the umbilical cord before separations of the infant. All 15 recommend various herbs to reduce pain (which I logged and recorded). None of the midwives allowed besides the mother and herself to be present during the birth. This is for spiritual and social reasons such as fear of the evil eye. All midwives interviewed suggest that the mother labor in a supine position, and not a squatting or standing position.
Midwives also have very individualized procedures that they use as well. One midwife always has her patient lay on a plantain leaf to control bleeding. Another washes out the newborn’s mouth with gin to “clear the lungs”. Throughout my research I recorded hundreds of various techniques used and beliefs held by the midwives.
When polled, most women say that they prefer to labor in a hospital. The reasons for this vary from sanitation, to increased amenities, to more faith in the training of the physicians. However, a large percentage of women still labor at home under the care of the midwife. Most women that have given birth at home claim that this was not their first choice, but lack of transportation, poverty, and lack of education in the utilization of available health services prevented them from using the hospital.
Changing Social Status
The importance of giving birth in Ghana cannot be overstated. The prestige gained by women who have children and the persecution heaped upon those unable to have children has effectively made the process of childbearing one of the most important goals of a young woman’s life. When asked, women say that the best part about having children was the increased respect of the community. These women feel as though after they became mothers, their clout and position in society increased enormously. Also, they feel as though the love their husbands have for them increased after giving birth.
Sterility or infertility is tantamount to a social death sentence in Ghanaian culture. While the infertile are looked after and allowed to work, they are forbidden from participating in key social or tribal rites. They are continuously mocked and called names and many people may attribute their barrenness to sorcery. Infertile women are often called witches and endure the persecution that such a title would warrant.
To prevent barrenness, women visit religious leaders, hospitals, and divinatory doctors who prescribe various forms of treatment. Throughout my research, I had the opportunity to visit with the witchdoctors and talk to them about their treatments of infertility.