Maternal Care: Technological Advancement, Traditional DeclineBy: Anika Huq

A family in the Sumraan village gathers before getting ready to eat lunch.

“The midwife tied a piece of cloth that was supported by the ceiling of my house around my hands. I squatted down, and the midwife applied pressure to my stomach, while I pushed for hours. Once the baby was out, the midwife used her fingers to scoop the baby’s mouth clean and tied the umbilical cord with bamboo leaves while I went to take a cold bath,” Song Khodtum, 87, a grandmother in the Koksi village in Khon Kaen reminisces about her birthing experience.

Her encounters are a far cry from the birthing experiences that her daughters and granddaughters have had. The days of endlessly lengthy and painful births are long gone and have been replaced with medically managed ones. Technological interventions have become commonplace, allowing women to have shorter and more convenient stays at hospitals.

“When it was time for me to deliver, I went to the hospital, delivered, and came back home. It was very comfortable, and I do not have complaints,” Sutasinee Sonbunton, 30, mentions.

Development, particularly in the medical field, is no stranger to Thailand. There has been a shift from home births to hospital births, and according to Dr. Charoenboon, the rates of C-sections have increased from 13.1% in 2001 to 23.6% in 2011 in northern Thailand, which coincides with the implementation of the thirty baht health scheme. In 2001, the Thai Rak Thai party introduced the scheme in order to increase the accessibility of health care. This was one of the party’s major platforms, and it was monumental in their success. In 2002, the thirty baht health scheme was implemented and eventually, the thirty baht copayment disappeared. Now known as the Universal Coverage Health Scheme, free health care has left an impact on mothers and how they care for their children.

The medicalization of childbirth comes with an important consequence that can sometimes go unforeseen. As an increasing number of citizens start to use more advanced health care, the past traditions and superstitions of keeping diseases at bay are slowly disappearing, and Thai childbirth culture is changing to one governed by technology.

Song is particularly attuned to the changes that the Universal Coverage Scheme has brought. “I delivered all of my children at home. However, it was not always the safest. I heard cases where the fetus was breech, and the mother and the baby passed away. With hospitals, it is becoming much easier for us to take care of those issues, and now, I rarely hear any complaints,” Song explains.

“In the past, mothers did not have any control while delivering because the technology to fix complications was unavailable. Therefore, mothers would follow superstitions because they did not have anything else,” Somphan Sompromma, 54, a health volunteer in the Koksi village mentions.

Some of these superstitions include the avoidance of sitting on stair steps, taking nighttime baths, attending funerals, and eating fermented foods. By doing so, women had some assurance that their child would be delivered safely and smoothly.

Moreover, past traditions have started to lose their authority due to plain impracticality. One common tradition was to bury a child’s umbilical cord in front of the house. According to Dr. Frazer, the umbilical cord is thought to have a strong connection with the life of the infant, and as a result, it should be properly preserved so that the child can be successful.

However, Tin Uddthaw, 72, a grandmother in the Sumraan village in Khon Kaen mentions, “I am not sure why I did that-it is what everyone else did. By the time my daughter gave birth, there was cement surrounding our house, so she could not bury her son’s umbilical cord.”

Furthermore, most of the traditions of the past were put in place so that children would be able to overcome societal barriers.

“Infants were placed on top of books so that they could gain knowledge. Before, most children were educated until they were about nine or ten years old,” Uttompon Seechai, 53, a health worker in the Khon Kaen slum community mentions. Higher education was valued, but it was not accessible. However, as it became more common, there was no need for this tradition to continue, and as a result, it started to become less practiced.

The commonality of hospital deliveries is influencing postpartum recovery methods as well. In the past, mothers would spend days next to a “U-fie,” a wooden like bed with heated coals underneath. “I spent fifteen days on the U-fie bed after the birth of my first child, five days after the birth of my second child, but for my third child, I did not spend any time next to the U-fie because of the technological advancements in health care. If something happens, the hospital staff will know what to do,” Nanyom Andang, 65, a health volunteer in the Khon Kaen slum community who delivered both at the hospital and at home, mentions.

Most mothers show appreciation for the increase in technological usage over the past years. “Because mothers visit the physician numerous times during their pregnancy, any projected difficulties with the delivery can be caught early on,” Peantong Moontep, 44, a staff member at the Sumraan health promoting hospital says.

Mothers do not seem to show resistance concerning the disappearance of traditional methods of birthing. Mothers have placed their faith in the hospital system, which is contrary to what those in more developed countries are doing. In the United States, the rate of home births has increased by 20% from 2004 to 2008, as home births provide mothers more control over the delivery process. More and more mothers desire the ability to find strength to endure the birth, rather than feel like their bodies require technological interventions (http://www.webmd.com/baby/news/20110520/home-births-on-the-rise-in-the-us).

This sentiment of empowerment through delivery has not reached Thai women yet. Instead, they seem to look forward to the hospital environment. “We no longer need our traditional knowledge because physicians have the knowledge to provide adequate care and ameliorate complications,” Uttompon mentions. Others have expressed similar sentiments. “I don’t worry that traditions are fading- it’s only natural. The superstitions do not hold up against medical knowledge,” Tin says.

Villagers, content with the strides in healthcare technologies, are looking forward to the future. Already, great progress has occurred throughout their lifespans.

“During the early years of my marriage, there used to be no method of birth control, so women had numerous children,” Kwang mentions. “As I got older, hormone injections, intrauterine devices, and pills became available. Now, mothers are able to display more control over when they chose to have children.”

As Thailand’s methodology of medical treatment comes to resemble that of the United States, it seems that villagers are willing to embrace hospital deliveries with open arms,

and the fading of traditional methods will not be questioned. As countries strive towards development, methods that rely on science and reason are thriving over those that do not.