The Role of the Traditional Birth Attendant in Rural Jamaica

Abstract

According to the World Health Organization, a Traditional Birth Attendant is an individual"who assists the mother at childbirth and who initially acquired her skills in delivering babies by herself or by working with other traditional birth attendants"(Feyi-Wabaso, p.676). As a product of a society which values the biomedical approach to the human body, 1 have a difficult time understanding why a woman would choose a birth attendant with no formal medical training. In the United States, one deals with normal biological acts, such as giving birth, with full preparation for the worst. Our medical approach is focused upon the pathological. Yet, while childbirth is a biological act, the practices and customs surrounding childbirth are a reflection of the culture in which the birth takes place. To understand why a woman might choose to be attended by a traditional birth attendant during birth, one would have to examine the culture in which the traditional birth attendant is the provider of health care to new mothers and infants, chosen over the biomedical doctor. In order to explore the perceptions regarding traditional birth attendants in a developing countries, I traveled to central Jamaica. Jamaica is a Caribbean island nation with a relatively well developed primary health care system in comparison with other developing countries. Yet, in the interior of the island, many women are still delivered with traditional birth attendants, who are called nanas. Much of the interior is rather isolated and rural. Those in the interior are generally farmers who still hold on to their traditional beliefs, as they are largely unaffected by increased modernization. While care is offered by the primary health care system, though it is far less available than in urban areas, women often choose the traditional method of delivery over that offered by trained health care workers. With the help of the Jamaican Ministry of Health, I was able to locate a traditional birth attendant with whom I could live with and study. I spent seven weeks with Miss Selma, in the district of Hedding. There I accompanied heron one birth, and observed her place in rural Jamaican society. I interviewed a number of women who had been attended by Miss Selma, as well as with a trained domiciliary midwife or in a hospital. Through these interviews, as well observations, I began to have a sense of why many women choose to the traditional method of delivery over medical practices which are often perceived to be safer.