| Description |
Field research was conducted in Hashtgard, Iran, from September 17, 1977, to December 24, 1977, with the purpose of identifying the childbearing practices of rural Iranian women, experiencing modern health care practices. Extensive ethnographic data was collected and provides a cultural frame of reference for the study. Of the 127 survey participants, all were Muslim, pregnant and had experienced an average of 3.2 deliveries. Slightly fewer than half of these deliveries had occurred solely in the home and had bee assisted by traditional birth attendants. The remaining deliveries had been experience in the hospital or both the home and the hospital. The majority of the participants wanted the pregnancy and denied the use of birth control in the past. Use of reproductive control measures, increased utilization of hospitals and professional birth attendants in the past, and a reported preference for modern health care facilities and practitioners for childbirth reflected a trend toward modern childbearing practices in this survey population. The survey also identified the transitional nature of this trend, i.e., 20% of the participants maintained a preference for a home delivery and traditional birth attendant assistance. The survey participants' descriptions of past childbirth, traditional birth attendants' attitudes towards childbirth, and interviews with women who had recently delivered appeared to indicate a fearful and painful perception of childbirth by women in this community. These identified perceptions may have reflected an illness-state attitude toward childbirth which was believed to require the assistance of an illness-oriented health care facility. The clinic was a familiar setting which provided female birth attendants who were thought to have techniques that would minimize have prevented some of the problems associated with childbirth. It, therefore, may have fulfilled a needed feeling of security for a majority of he childbearing women in this community. The traditional birth attendant' role (N=3) appears to have become circumscribed to include supportive, religious and consultative functions throughout the childbearing process, but particularly during childbirth and the postpartum period. The support and explanations given by traditional birth attendants and family members were considered important to cope with the birth process. Religious tasks of the traditional birth attendant were based on Islamic teachings and were performed at childbirth and on the tenth postpartum day. Reported and observed changes in traditional birth attendants' practices and beliefs were related to the incorporation of aseptic techniques, the recognition of a need for modern practitioners to handle complications of childbearing, and the cessation of practices perceived as old-fashioned and irrelevant. Modern childbearing practices which are considered inappropriate by tradition birth attendant may have been incongruent with strong cultural beliefs and customs which influenced traditional birth attendant practices such as episiotomies, vaginal exams, etc. The results of this study describe a childbearing population which was attempting to harmonize over short time span modern childbearing practices with proven customs and beliefs. Traditional birth attendants through their supportive and religious tasks were perceived by the investigator as community members who may be able to provide the necessary linage between past, present, and future childbearing practices. |
