Modern obstetrics in confrontation with a traditional birthing system—an example from Korea

Abstract

This paper presents some results of an ethnographic study on and an obstetrically qualified analysis of childbearing in rural Korea. The study was designed to obtain a better understanding of the inadequacies of the modern obstetrical and maternity care services as experienced by the author in a decade of work with such services in rural Korea. The study was also designed to elucidate traditional Korean birthing behavior, to gain insight into the impact of modern obstetrical services on the pregnant rural woman, and to assess the obstetrical pathology associated with unattended childbirth. The study was community-based, and involved a population of 14,000. Selected for study were all women who became pregnant between September 30 and December 31, 1977, who were registered by home-visiting local health workers by March 31, 1978. The 30 women thus identified represented approximately 50% of all women who had become pregnant during that time in that area. These women and their families were followed through pregnancy, childbirth, and puerperium on the basis of ethnomethodology by highly qualified, highly trained, and well-supervised Korean research assistants in the behavioral and medical sciences. This paper presents some of the research results including the features of the traditional Korean birthing system, the features of the modern obstetrical system, an example of rural childbearing, and a presentation of the documented pathology, which is discussed against the background of confronting modern obstetrical and traditional birthing systems. It is concluded that the pathology of unattended childbirth is probably higher than was previously thought, and that the confrontation of the two birthing systems is detrimental to the health of childbearing women. It is suggested that the observed situation may be similar to that in many traditional cultures under acculturation. It is postulated that in research, training, and practice, modern obstetrics should supplement its biomedical orientation with an understanding of the cultural anthropology of birthing. This would help not only to improve obstetrical services in relation to the needs of women but also to make it easier to control and direct the impact of undesirable results of obstetrical services in developing societies as well as in our own.