Childbirth The Panama Way




The Embera people once lived deep in the forests of Panama. Now, they live in purpose-built communities on the banks of the Ipeti River, having been run off their land by logging companies and Colombian guerrillas. These days, 'progress' and the ever-growing cosmopolitan city of Panama have influenced their lifestyles, and many of their cultural practices have disappeared. Their strong medical traditions survive, however. Alba Casama, a 42-year-old mother of six, describes the unique process of pregnancy and birth in the Embera community

My first baby was born in the river; all the rest were born at home. I was 17 years old when I found out I was pregnant. I was frightened and didn’t know what was happening. When I told my mother, she was happy for me. I had no prenatal care, since we don’t do that here. I was lucky because I felt nothing during pregnancy. I wasn’t ill and had no fever or vomiting. I must be a strong woman. As soon as I found out I was pregnant I stopped eating things like coconut, avocado, guaranabara and cacao. I also had to stop eating armadillo and carchovia [a type of fish], because they live in the rivers between the land and water. According to our tradition, if you eat these creatures your baby will be born with a big head. It can be all right to eat a little coconut, in little, tiny pieces, but I preferred not to risk it.

When you are pregnant, babies and children must not be allowed to walk over your legs. If they do, the baby might be born in the breech position. As there are always so many children running around in our community I was quite nervous that it might accidentally happen. But it never did. I was always on guard against it.

When I was at about five months, I went to see the partera [midwife] for the first and only time until the birth. She checked the health of the baby using her hands; she presses quite hard on your stomach, which can be a bit uncomfortable.   Some of my friends felt terrible during their pregnancies; they were ill and vomited. But I was lucky: the only thing I felt at times was a bit of colic. My mother would make me some ginger tea and it would work immediately. When I started to feel the contractions, I was so frightened and thought I was going to die. That’s partly why so many people attend to you when you're in labour (in our culture, four women help with the birth): they help you not to be afraid. When I began to feel the pain, I sent a friend to fetch the partera.
When the partera came she took me to the river, to the spot where our children have always been born. She made me hold on to a branch above me, then she stood in front of me, wrapped a cloth around my stomach and pulled down on it. Leaves were spread out on the ground beneath me so that the baby could be born onto them.

When my daughter was born I felt so emotional, overwhelmed and so very happy when she was laid in my arms, that I forgot all the pain I had experienced. The next thing that happened was that the baby’s umbilical cord was cut. The partera cut it using the head of an axe. Then the baby was washed – first in the river and then, as the waters of the river are cold, in the warm water that one of the assistants has been heating by the side of the river. One woman cleans the baby, one cuts the cord, one swaddles it in cloth and the other looks after the mother. Afterwards, if the placenta doesn't out come easily, the partera ties a heavy rock to the umbilical cord. But with all of my babies it came out easily. After the birth the placenta is buried. It is never thrown away, as if you throw it away it would be thought of as a rejection of the child, and the child would then be thought of as difficult or naughty.   

The assistants cleaned both the baby and me with special medicines to prevent infections and give us strength. Then the partera gave me some tea made from a plant we call dama cambu to control the pain and lessen the bleeding. When they brought us back home from the river they washed the baby again with warm water. All my sisters and family were there when the baby was washed again.It is a tradition that, after the birth, everyone who has participated in it or has been waiting at home has to go to the river and bathe. This tradition still happens today. Everyone, even the littlest babies and children, whatever time of day or night the baby comes, has to bathe in the river. This is to ensure that the baby will be a force for good.

I only had trouble with one of my babies. It refused to come out. There were three partera with me and at the last minute they called the jaibana [medicine man]. He made me a hot tea – I have no idea what it was – which caused me to feel dizzy and fall down. When I woke up the baby was there. That was my daughter, Sarah. Years ago, back when we still lived in the jungle, we would only ever use the jaibana. My brother had an interesting birth: he was born in a boat. My mother wasn't prepared for him as he came three months early. She tells me that he was no bigger than her hand to just above her wrist. She took him all the way to Panama in a pirague [canoe] to see a doctor, which took a whole day. The doctor said that he wouldn’t survive, but he did and he is just fine today.

Up the river, there is a lady who had the same problem. She gave birth to a daughter after only five months of pregnancy. Her husband put the tiny little girl in a bag and carried her all the way down the river. When he brought her to the nuns they thought she was a rabbit – until they heard her crying. They took her to hospital, and after eight months she came home. It’s hard to believe, but she is absolutely fine.

Alba Casama was interviewed by Susan Schulman