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Culture shock: a birth story

How giving birth was the greatest culture shock I experienced since moving to the US

Photo of Arjanna Plas
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1,5 year ago I moved from Amsterdam to San Francisco. I was prepared for a culture shock in the first weeks, but it only came after one year, when I was pregnant with my first daughter.

In the Netherlands childbirth is not seen as a medical condition, and pregnant women are not be treated as patients. As a result pain relief is not encouraged (only about 10% of women use it) and home births are standard (about 30%). The role of the doctor or gynaecologist in a normal pregnancy in the Netherlands is minor and in most cases they're not involved at all: midwives, who collaborate closely with hospitals if necessary, are in charge.

Coming from a culture where childbirth is seen as a natural event, the extensive care that was provided to me in San Francisco was actually stressful for me, as it made me worry about what could go wrong, whereas my natural (cultural) tendency was to trust in myself and the baby.

After coming home exhausted from an extra antenatal screening that my obgyn had kindly offered me 'to make sure everything was ok with the baby', I realized something needed to shift. I explained to my obgyn that the extra tests made me feel like a helpless patient rather than an empowered mother-to-be. My comment came as a surprise to her, but improved her care for me in the weeks leading up towards the birth by allowing me to be in the lead, rather than her offering solutions.


What is a provocation or insight that might inspire others during this challenge?

The way a woman experiences pregnancy and birth is highly culturally sensitive. It is essential for care providers to understand the woman's background in order to provide care that optimally supports the woman and her baby.

How does this research relate to our use cases and personas?

This insight relates to the third persona, the care provider, especially Ana the neonatologists who doesn't have enough time. In my case, my obgyn would have been able to spend less time on me if she knew from the start that her extra care didn't serve me the way she expected it would.

Tell us about yourself:

I'm trained as an industrial design engineer.

Are you currently an employee of Sutter Health or UCB Pharmaceuticals?

  • No

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Photo of Peju

Thank you Arjanna!
I think one of the issues that is we neglect in the planning of health care delivery is the patient's behavior, attitude and beliefs about what we are offering, assuming of course that the medical services, developed in a cultural setting that is different from our patient, is not only better, but that the patient should instinctively see it as so.
I work as a physician and in close contact with antenatal services, we continue to scratch our heads about why, in spite of the policies implemented for safe motherhood, (mostly assuming that the modern medicine and its services are better, and if we build more hospitals they will come) many Nigerian women living in cosmopolitan Lagos do not visit their OBGYN as many times are recommended by the WHO, or many times enough to qualify for bare minimum.
The traditional birth attendant (who they prefer to visit) has a more enabling environment for our patient, it seems, and one thing they get right, apart from the customer intimacy, (easier to set up in a less professional setting), is the joint belief with the patient that the pregnancy is a natural phenomenon.
 Home births, sometimes unskilled, still abound because of the upheld fact that a woman's body is designed to give birth naturally.
How does the modern physician agree with the patient, and yet get the patient on her/his side, and how will be affect the design of modern medicine services, antenatal services being a prototype for this?
Thank you Arjanna

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