Heart Burn

          I have to say, I've had one of the most interesting weeks.  Yet, again I am amazed at the magnitude of how social circumstances can manifest as "heart burn."  It seems that women today continue to be afflicted by their circumstances while maintaining some sort of balance in their lives.  While looking at the bigger issue, it is no wonder one of the major causes of death for women is cardiac related.  Do we really take our emotional issues to heart?  Or is it socially acceptable to place an outward appearance of strength and stability, when really you are doing your best to just get out of bed every morning? At which, emotional instability begins to manifest itself in other physical forms. It seems that women's health issues need to be addressed from a feminist perspective, which would explore and incorporate a woman's health from within the context of how women live their lives, collectively and individually within a patriarchal society.  This perspective incorporates social, environmental, and economic aspects of women's health, which is vital to understanding how women are able to achieve health and well-being (Womens Gynecological Health, 2006).

          With that said, I wanted to shed some light on some of the issues that women are facing today.  I think for those of us who are health care providers or working within health care, these women are usually the ones that continue to come in to be seen for varies health issues during pregnancy or for other gynecological crises.  When taking a closer look at their background you may find that they have an extensive social history ranging anywhere from depression, anxiety, abuse, homelessness, and the list goes on and on....Some of these women may have partners that are in and out of their lives, but they continue to bare the burden of raising their families alone and with little resources.  So again, are we really treating "heart burn" or is it a physical manifestation of their circumstances?  Apparently, 60% of patients coming into primary care have clinically significant mental health issues. Furthermore, while researching barriers to prenatal care among the Native American population in New Mexico I was somewhat surprised to find that among the top five reasons Native American women may not seek out prenatal care or there is a lack of prenatal care, are belief systems, family dysfunction and low socioeconomic status.  Findings that supported these reasons were that there was association with lack of transportation and childcare, traditional belief systems and family dynamics. 
          Obviously these issues are so complex that a 15 minute visit with your physician, midwife, or nurse-practitioner will most likely not fix the problem.  So what will?  Unfortunately, I do not have that answer for you.  I think it is important to keep a running dialogue among health care providers so that there is an awareness of the issues that our Native American communities are facing.  I realize seeing at least 20 patients on a daily bases with varies complex health issues can numb your senses as to what is going on in the home setting for these women, but some level of understanding and sensitivity needs to be maintained.  Because, when you see these women, you are not just treating heart burn.

Outreach

          One of the purposes of my blog was to give first hand knowledge of what it is like to go through a midwifery program from a Navajo perspective.  Upon entering the graduate program I was amazed to find that even though 75% of all Native American women in the U.S. received women's health care from midwives, there is only a limited amount of Native American Nurse Midwives that practice in the United States at this time.  Currently in our state of New Mexico there is only one Native American Nurse Midwife practicing.  Why does this matter?   Long before Indian Health Services became part of the "normal" childbirth rituals for our Native women, a majority of our childbirth practices was provided in the home and usually by a family member who was knowledgeable about traditional childbirth practices.  Over time these traditional childbirth practices have been abandoned and a "Blessing Way Ceremony" was replaced by a doctors visit. I realize that historically Indian Health Services was necessary to help correct the increasing loss of mothers and babies to illness prenatally, postnatally, and in labor.  However in the process it seems there has been very little meshing of our traditional philosophies and way's of life with the Indian Health Services model of care.  As a good mentor of mine has said.." there is no INDIAN in Indian Health Services."   
          I believe that most Native American providers will find themselves in a unique position to walk between the two worlds of our traditional healers philosophies and the western medicinal philosophies.  We have something to offer with a unique perspective that only we can understand and provide to the communities we are helping. So for those few individuals who find themselves walking this path, I wanted to help nurture that drive with my experiences and knowledge.  This is why I find it vital to encourage Native American women to consider Nurse-Midwifery as a path for them. I realize up to this point I have talked about things from an emotional perspective rather than specific experiences, but really it has been the emotions that have been most memorable.  Unexpectedly I have found a deeper connection with my own culture and a deeper respect for our traditional philosophies as it applies to pregnancy and childbirth.  I am amazed at how vital our traditional teachings are and how immersed in the care of our bodies and minds they are.  It is our traditional philosophies that carry us and that shape our minds to view the world in a different way.  It is with this perspective I want to share in the care of women.
          For me, part of the journey is to help educate young students about Midwifery.  As a young student in high school I never realized ones ability to impact others.  I looked up to those who were known leaders, but I never considered myself as one.  I have to say, I don't think I would have been ready for this role if it wasn't for my children and husband who have helped mold me into a woman who speaks up.  Even the very challenging events in my life have taught me to speak up and not get stepped on.  My point is, know matter your circumstances, you have many opportunities to grow from them.  You can't let your circumstances keep you from reaching your potential.  We all know that Native Americans have been marginalized for years, but that shouldn't be an excuse to marginalize ourselves and never see beyond our own circumstances.  I think for a Native American high school student to connect with someone who grew up under similar circumstances who now is in a position to lead in any field of education or profession can be very empowering.  It is kinda like..I am here now, but I want to be there later.  Now how do I get there?  Planting the seed is just the first step.  Personally, I am not surprised to see and hear that more and more Native Americans are entering health fields.  Based on my personal observation most of us excel with hands on learning.  We tend to do more listening then talking. Perhaps we have our ancestors to thank for that.  Lets just say our instincts have been rooted in our understanding of nature and natural life cycles. 
          It may be that what I'm talking about is already known by many, its just no one is talking about it.  Which I consider another Native American trait, we know what is going on, but don't expect us to always be talking about it.  All I know is...this indian is talking about it.