Documented studies show that the levels of care for minority patients and individuals from uncommon social groups are not equal to the care given to other patients within professional medicine. Cultural difference, language barriers, stereotypes, racism, homophobia and contradictory religious affiliations often affect health outcomes. Medical professionals who do not share a patient’s cultural background or who do not speak the same language have a harder time explaining necessary treatments, health care strategies and test results to those patients. If clear communication in the patient’s primary language is not available, if the medical professional does not treat the patient with an appropriate level of concern, if the patient feels their identity or religious choices are not approved/understood/respected by their medical team, health outcomes are affected. It becomes less likely that patients will ask questions to clarify points in their health care plan. They are less likely to follow legitimate prescriptive courses of action to address their health situation. They often become unwilling to seek medical attention or to trust medical professionals or institutions. This lack of trust in the medical profession is often passed down to their descendants as well, which in turn affects the health practices of the younger members in the family.
Many tribal members will recognize this pattern – we have lived it or seen our neighbors and cousins do so. How many Indigenous people have stories of terrible medical practices utilized by Indian Health Service and other medical practitioners in the past (forced sterilization, poorly communicated and traumatic surgical procedures, impossibly long wait lists for needed medical services, etc)? How many of us still find it strange (or even scary) to be in a doctor’s office for an appointment? How many of us have had to promise other family members we would not take them to the hospital no matter how bad their ailments become?
I know several Indigenous medical professionals who turned to that line of work for reasons exactly like the above. They experienced horrible medical situations with people they cared about who were untrusting of modern medicine practitioners. They hoped to make it easier to trust modern medicine practices by learning it themselves, being someone already trusted in their community. They meld the modern medical practices learned from their studies and the traditional cultural teachings of their tribe into something new – a modernized medicine person with older herbal and tribal knowledge at their fingertips, as well as the knowledge of how to use dialysis and bypass machines. This has been wonderful news for our tribes and has helped indigenous people to get much needed medical attention.
One of the places where cultural care makes huge impact in health outcomes for patients is within pregnancy. Pregnancies where prenatal care happens more often, within a culturally sensitive environment and with medical practitioners aided by doulas often see much better results. Women who are given holistic, culturally based medical attention during their pregnancy tend to have easier deliveries. Their babies are less likely to be born preterm and are less likely to need resuscitation after birth. A recent study published in the Medical Journal of Australia (MJA) confirmed that a group of Indigenous pregnant women who were treated by Aboriginal midwives, grandmothers and other health professionals giving holistic medical care often had better health outcomes at the time of their delivery. It is not the first study to find such a result.
Pregnant women tend to have fewer complications with their pregnancy when they have adequate prenatal care, holistic medical treatment and the assistance of a trained doula throughout their pregnancy and delivery. This is not the model for pregnancy utilized by many modern medical institutions. Midwifery, doulas and holistic care are still not considered as common choices for modern pregnant women but studies like the one above prove why they should be. Due to the distrust many Indigenous people have of medical practitioners, as well as the distance we have to travel to visit a medical institution, we often put off seeing doctors for too long. We do not go in for the checkups we should. We do not seek treatment for ailments as we should. We put off finding out if we are pregnant for too long, then rarely go in for medical checkups. Utilizing holistic, cultural based care as well as having medical professionals who come from our tribes will help us lead longer, healthier lives from birth. It can help us all heal from past medical traumas and make our youth healthier from the start.