La Paz - Seminar on Natural Birth & Acupressure for Birthing

La Paz is very ironically named. It is chaotic and non uniform. Driving around the city, it feels like each area was built in deliberate defiance of the proportions and layout of the previous one. Like in a child's imagination, steep narrow alleyways can open up to bustling market towns and negociating the public transport system is like playing a fast computer game without knowing the rules. Similarily the inhabitants seem to occupy different worlds within one city. There are the slick suited business men, the leather faced indigenous women carrying their babies on their backs in rainbow striped textiles and the 'cholas' who wear gypsy like gathered skirts in subdued colours and bowler hats. For ten days we huffed and puffed our way around this oxygen-poor city, with our busy schedule of acupressure workshops, seminars on natural birth and singing workshops. Here I describe a seminar on natural birth and one of Judith's acupressure workshops.

Our first mission, with Judith, Tania, Cearbhuil and I, was to attend a seminar on 'rehumunisation of birthing practices', in the city centre. The session consisted of a number of presentations by Bolivian health care professionals, an input from Judith on her work in Ireland around facilitating natural birthing and most intrestingly for me, a presentation by Valentina, an Aymara 'partera', or traditional midwife. Instead of formal medical training, Valentina has what she descibes as a 'natural gift' for delivering children, an ability she receives from the 'pachamama', from Mother Earth. She has assisted in hundreds of births with no fatalities. However, the medical establishment ignore and reject her work, and that of many traditional
midwifes. The debate centred around this dichotomy - the male-dominated, euro-centric medicalised modern birthing method (largely in hospitals) and the woman-centred, traditional or neo-traditional natural birth (often at home). Putting this debate in perspective, Haiti and Bolivia have the highest pregnancy and birth risk levels in Latin America, and in 2003 there was a rate of 229 maternal deaths for every 100,000 live births. Many maintain that the solution to the problem is more medicalisation, while others believe that more understanding of the cultural practices of the majority indigenous population is necessary. Many isolated rural indigneous women do not have access to western medical care, but many deliberately do not access medical intervention because they do not feel they will be treated with understanding and respect by the health care professionals. The perspectives on this debate by the women's cooperative who hosted many of our meetings in Bolivia, Las Imillas, are described in this article http://www.herriak.org/ki/index.php?option=com_content&task=view&id=129&Itemid=37

A few days later, a workshop was scheduled in acupressure for pregnancy and child birth. Acupressure is a traditional Chinese medicine (TCM) technique based on the same ideas as acupuncture. Acupressure involves placing physical pressure by hand, elbow, or with the aid of various devices on different acupuncture points on the surface of the body. About 20 woman, mostly involved in the health care or social work professions attended the workshop. Judith taught points to press for various stages and issues in pregnancy and child birth, including nausea, lower back pain, high blood pressure, loss of conciousness, cramps and even breech position. The beauty of this technique is that it is relatively easy to learn, it is free and accessible for everyone. Although it reflets a vastly different world-view and comes from a medical sytem distinct to both the western and indigenous Andean ones, it does not require a change in beliefs for a person to practice acupressure.

The next activity on our schedule was my first singing workshop in El Alto, the highest and poorest part of La Paz.