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Native American Postpartum Pregnancy Traditions:

Historically, some Native American women would deliver their babies alone in a quiet place. Some tribes, such as Sacajawea’s tribe, the Shoshone, would allow the mother and grandmother to attend the birth, but in almost all cases, men were not allowed to be present. This was violated during Pompy’s birth, as Lewis was present. Navajo women would also chant or hold onto sacred items during delivery. 

Among the Mohawk and Mohican Indians, pregnant women would “depart alone to a secluded place near a brook, or stream of water . . . and prepare a shelter for themselves with mats and coverings, where, provided with provisions necessary for them, they await their delivery without the company or aid of any person. A woman in labor stood, knelt, or sat, but she never gave birth lying down. Usually no one bothered to catch the baby, who fell onto leaves placed beneath the mother.

Many tribes had rituals intended to protect the new baby. The Shoshone buried the umbilical cord to ensure certain character traits, such as ambition. The Navajo buried the placenta as a way to protect the newborn from evil spirits. Other tribes required new mothers to plunge the newborn into a nearby river every day for the first two years of life, which was believed to keep the baby healthy.

During their pregnancies, women restricted their activities and took special care with their diet and behavior to protect the baby. The Cherokees, for example, believed that certain foods affected the fetus. Pregnant women avoided foods that they believed would harm the baby or cause unwanted physical characteristics. For example, they believed that eating raccoon or pheasant would make the baby sickly, or could cause death; consuming speckled trout could cause birthmarks; and eating black walnuts could give the baby a big nose. They thought that wearing neckerchiefs while pregnant caused umbilical strangulation, and lingering in doorways slowed delivery. Expectant mothers and fathers participated in rituals to guarantee a safe delivery, such as daily washing of hands and feet and employing medicine men to perform rites that would make deliveries easier.

Some ritual practices continued for a period of time after the birth. 

The Shoshone tribe required the new mother to live alone with her baby for the first month to foster a bond between the two. This was not adhered to in Sacajawea’s situation, due to Lewis and Clark’s fervor in demanding that the expedition be accomplished within a concrete period of time. Another Shoshone custom concerned dietary restrictions, requiring new parents to refrain from eating red meat for several weeks after the birth of the baby. Many Indian tribes held a naming ceremony several days after the baby was born.

According to the National History Education Clearinghouse, in almost all cases, Native American mothers would return to their usual duties very quickly. To allow new Native American mothers to resume their duties, Native American babies were swaddled and strapped to a cradleboard, which was carried on the mother’s back. Though cradleboards are still used, many Native American mothers opt for a more modern way to carry their baby, such as a baby sling.

Beliefs, Values, and Taboos:

The beliefs, values, and taboos regarding pregnancy, labor, delivery, postpartum, and newborn care vary from tribe to tribe and from individual to individual, but the health care provider should be aware of some of the commonly practiced traditions of Native American families. 

The geographic location (urban or rural), generation of the individual, and their degree of involvement with extended family and other tribal members when assessing the cultural beliefs of clients also must be considered. These beliefs are part of the life view for Native Americans, and it is counterproductive to refer to them as old wives tales, superstitions, or myths. 

The individual practices and beliefs of women and their family members can be 

easily assimilated into hospital or clinic care. Examples of such practices are apparent in clinical practice or in the literature.

Native American Maternal-Newborn Beliefs and Taboos:

1. A pregnant woman should not look at a deformed, injured, or blind person or the baby will have the same defect. 
2. Being around dying people or animals is unhealthy for the mother and baby. 
3. If a pregnant woman eats animals’ feet, her baby will be born feet first, or breech. If the pregnant woman eats the tail of an animal, her baby will get stuck during delivery. 
4. If berries are eaten during pregnancy, the baby will have a birthmark. 
5. If liver is eaten during pregnancy, it will make the infant’s skin darker. 
6. To tie knots or weave during pregnancy will cause complications of the umbilical cord at birth.
7. Preparation such as choosing a name or making the cradleboard prior to the birth of the infant may jeopardize the infant’s survival or well-being. I just mentioned that Native Americans are present focused, and many tribes held a naming ceremony several days after the infant was born. 
8. Albinism is believed to be caused by the father eating the white leaf inside the corn husk before conception. 
9. If the father shoots a rabbit or other small animal, the child will have a mark or deformity in the same area the animal is shot. 
10. If a snake is killed, the infant will be born spotted like the snake and die.
11.  Different tribes clearly specify the appropriate dress, position, and who is in attendance for birth, as well as dietary and bathing specifications during the postpartum period. 
12. During labor, a badger’s claw may be put in the woman’s belt because the badger is good at digging his way out.
13.  A nap during labor may result in a change in the desired sex of the infant. 
14. Exposure to cold during pregnancy may result in a lengthy labor as the cold may freeze the woman’s bag of waters, or amniotic sac, and hold the baby back. 
15. If a raw bean is swallowed during labor and it slipped down with ease, the delivery will be easy.
16. While the infant’s cord is being cut following birth, the mother bites on a white pebble to ensure the child’s teeth will be strong and white. 
17. The placenta and umbilical cord (including the cord stump), as any body tissue, is sacred to the Native American people and should not be discarded indiscriminately. 
18. Most newborns are swaddled, breastfed, and greeted with a special ceremony depending on the tribe and the sex of the infant. 
19. After the cord stump falls off, the navel may be treated by rubbing it with dirt from the doorstep. This trodden dirt is used because it is believed to keep the navel down and in place.

Although death is not usual in maternal-newborn health care settings, it does occur. Understanding the tribal beliefs and taboos associated with death and dying is crucial in providing culturally sensitive care. 

My DEI family: Remember cultural competence, cultural humility, and culturally sensitive care from the previous episode of this podcast?

Let us exercise placing theory into practice in the care of Native American patients.

Open expressions of grief may not be appropriate or therapeutic when caring for a Native American who is in the process of dying or whose loved one has recently died. Grieving for someone in the process of dying is viewed as hurrying the dying process. Ventilating feelings about someone who has died is also unacceptable because these expressions are believed to hold back the spirit of the deceased Native American.

Do no harm, my doctors.

Do no harm, my people.

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