A cosmopolítica da gestação, do parto e do pós-parto: autoatenção e medicalização entre os índios Munduruku / The cosmopolitics of pregnancy, childbirth and postpartum: self-attention and medicalization among Munduruku Indians

A pesquisadora Raquel Paiva Dias-Scopel, do Instituto Leônidas e Maria Deane (ILMD/Fiocruz Amazônia), levanta questões sobre a valorização e respeito à diversidade étnica e cultural dos povos indígenas e a difícil interface com o processos de medicalização e do direito ao acesso aos serviços de saúde biomédicos. O livro é parte da Coleção Saúde dos Povos Indígenas, da Editora Fiocruz e partiu da tese de doutorado defendida em 2014 no Programa de Pós-Graduação em Antropologia Social da Universidade Federal de Santa Catarina (UFSC). Foi publicado pela primeira vez em 2015 pela Associação Brasileira de Antropologia com o título A Cosmopolítica da Gestação, Parto e Pós-Parto: práticas de autoatenção e processo de medicalização entre os índios Munduruku. No prefácio da primeira edição, sua orientadora, a doutora em antropologia e professora titular da UFSC, Esther Jean Langdon, ressalta que o conceito fundamental deste livro é da autoatenção, que aponta para o reconhecimento da autonomia e da criatividade da coletividade, principalmente da família, como núcleo que articula os diferentes modelos de atenção ou cuidado da saúde.

Creencias y vivencias de mujeres adultas sobre la menstruación en el municipio de Cota, Colombia / Beliefs and experiences of menstruation on adult women in cota municipality, Colombia / Crenças e vivências de mulheres adultas sobre a menstruação no município de cota na, Colômbia

Objetivo: Conocer y documentar las connotaciones culturales, las prácticas de cuidado y los estilos de vida en torno a la menstruación, en mujeres adultas del municipio de Cota. Métodos. Se llevó a cabo una investigación cualitativa dentro de un contexto individual y sociocultural, caracterizada por un enfoque teórico etnográfico y fenomenológico. Se incluyeron 28 mujeres voluntarias, entre 48 y 97 años, que fueron referenciadas por reconocimiento de la comunidad y seleccionadas por muestreo de tipo “bola de nieve”, a quienes se les hizo una entrevista semiestructurada analizada por edición. Resultados. Existe un cuerpo de conocimientos que cimenta el saber de la medicina tradicional en el municipio de Cota, los cuales incluyen prácticas que han prevalecido a lo largo de los años y que hacen énfasis en cuatro áreas: la dieta, el cuidado del cuerpo con el equilibrio frío-calor, el uso de plantas medicinales y las restricciones sociales. Para ofrecer un cuidado culturalmente congruente, se deben conocer las creencias y prácticas relacionadas con la menstruación, lo cual facilita la interacción en el cuidado y la intervención en la atención de los servicios de salud, con base en sus propias creencias y valores.

Objective: To learn and document life styles, beliefs, practices and therapeutic treatments regarding menstrual care, used by women from the municipality of Cota, Colombia. Methods: A qualitative investigation characterized by a theoretical ethnological and a phenomenological approach was carried out, within an individual and socio-cultural context. Twenty eight voluntary women between 48 and 97 years of age were included, refe- rred through community recognition and selected by snowball sampling. Additionally, semi-structured inter- views were applied to all the participants and analyzed through edition or classification. Results: In the municipality of Cota, Colombia, a body of knowledge exists that supports traditional ancestral medicine and wisdom, within which there are practices and customs that have prevailed through the years and that emphasize or focus on four areas: diet, taking care of the body using heat and cold balancing methods or practices, and social restrictions or taboos. In order to offer culturally congruent medical care, the physician must acknowledge and become familiar with the traditional ancestral practices and beliefs regarding women’s menstrual care, so that in the future he/she can determine which of them are important to preserve, adapt and restructure, facilitating interaction during both the care and the intervention phases accomplished by health service institutions and personnel, by taking into consideration the patient’s beliefs and values.

Objetivo: Documentar as conotações culturais, práticas de cuidado e estilos de vida a respeito da menstruação entre mulheres adultas no município de Cota. Métodos: Pesquisa qualitativa fenomenológica que incluiu entrevistas semiestruturadas, analisadas por edição, a 28 mulheres voluntárias com idades ente 48 e 97 anos, amostra referenciada por Bola de Neve. Resultados: Existe no município de Cota, um saber baseado na medicina tradicional que inclui práticas antigas que se focam em quatro aspectos: dieta, cuidado do corpo (balance frio-calor), uso de plantas medicinais e restrições sociais. Para oferecer e facilitar um cuidado médico culturalmente coerente é importante conhecer as crenças populares sobre este período da mulher.

How menstrual shame affects birth.

In Western, industrialised culture, menstruation and birth are commonly seen as unstable, pathological processes requiring medical control. Girls learn to see menstruation as shameful and secretive. Menarche is a nodal event around which girls' beliefs and attitudes to being female are organised. The perception of menstruation as a liability has foundational implications for future female experiences, particularly birth. Other cultures have recognised menstruation and birth as spiritual phenomena, with menarche and childbirth experienced as powerful initiatory processes. My PhD research explored the links between cultural attitudes to menstruation and spirituality, and women's experiences of birth. My feminist perspective recognised the power imbalances, patriarchal controls and structural inequities that oppress women in their intimate body experiences. Menstrual shame was identified as a core patriarchal organising principle that inculcates and perpetuates male dominance and female subordination. Engendering the perception of female physiology - and thus womanhood - as inherently flawed, menstrual shame was a key factor that predisposed women to approach birth feeling fearful, disempowered and vulnerable to intervention. However, my research also unearthed a counter-cultural group of women who had transformed their relationship with both menstruation and birth. Redesignating menstruation as a spiritual phenomenon enabled these women to dismantle their menstrual shame, connect with their female spirituality and give birth fearlessly and powerfully. For others, the profound spirituality of birth transformed their understanding of menstruation. Contrary to cultural norms, both menstruation and birth can be sacred female experiences which are sources of authority and empowerment.

[Women, bodies, and Hebrew medieval medical literature]. / Mujeres, cuerpos y literatura médica medieval en hebreo.

This essay explores different views on the female body articulated within Hebrew medieval texts on women's health care. It also investigates whether texts also integrate women's own perceptions of their bodies, and of their needs and care. I have analysed how this genre of Hebrew literature understood two key issues in the construction of sexed bodies: menstruation and cosmetics.

Menstrual madness: women's health and well-being in urban Burma.

Women's health in peri-urban Burma is conceived of in terms of blood, strength, and the relationship between the body, the body politic, and the local environment. The regulation and volume of blood at menstruation and childbirth are the fundamental indicators of health and well-being. Well-being is contingent on harmony in and between the body and the universe. Blood flow is a key symbol through which women's beliefs and practices concerning their health and well-being can be understood at the levels of pathophysiology, interpersonal relations, the local environment, and the wider political and moral economies of urban Burma.

Indigenous practices of Saudi girls in Riyadh during their menstrual period.

The objective of this study was to identify the indigenous menstrual hygiene practice of Saudi girls in Riyadh. A total of 600 girls aged from 11 years to 18 years were selected from outpatient clinics at three different hospitals in Riyadh. Data were collected using a structured interview. The results revealed that nearly two-thirds of the girls avoided certain foods, drinks and activities, including showering and performing perineal care, and practised several indigenous rituals during the period. Mother, religious books and sisters were the main sources of the girls' infomation. The study suggests that nurses and health care providers should use all available opportunities to educate young girls about menstruation.

Women's hidden transcripts about abortion in Brazil.

Two folk medical conditions, "delayed" (atrasada) and "suspended" (suspendida) menstruation, are described as perceived by poor Brazilian women in Northeast Brazil. Culturally prescribed methods to "regulate" these conditions and provoke menstrual bleeding are also described, including ingesting herbal remedies, patent drugs, and modern pharmaceuticals. The ingestion of such self-administered remedies is facilitated by the cognitive ambiguity, euphemisms, folklore, etc., which surround conception and gestation. The authors argue that the ethnomedical conditions of "delayed" and "suspended" menstruation and subsequent menstrual regulation are part of the "hidden reproductive transcript" of poor and powerless Brazilian women. Through popular culture, they voice their collective dissent to the official, public opinion about the illegality and immorality of induced abortion and the chronic lack of family planning services in Northeast Brazil. While many health professionals consider women's explanations of menstrual regulation as a "cover-up" for self-induced abortions, such popular justifications may represent either an unconscious or artful manipulation of hegemonic, anti-abortion ideology expressed in prudent, unobtrusive and veiled ways. The development of safer abortion alternatives should consider women's hidden reproductive transcripts.