Updated: Mar 23, 2020
The depiction of traditional midwifery allows midwifery to be socially exclusive to the elite white middle class, which comes from exploiting under developed countries for unsanitary or outdated conditions of birthing. In the case of Zimbabwe, not only is fertility a cultural staple, but a nationalist agenda due to concerns of global influence.
Accommodating the population of which 2/3 of the people reside in rural areas, the social custom of manhood being contingent on impregnating a woman you will marry, is not the only driving factor behind traditional midwifery being socially accepted. The ideals of western medical practices, pivoted against traditional birthing has always left nations that fail to accommodate their greater population in the modern sense, being dirty because the midwifery isn't an elitist option.
In modernizing, Zimbabwe experienced a significant decline in maternal mortality; in 1980 there were 145 maternal deaths per hundred thousand live births that versus 76 in 1988 would create the perception that western medicine is more practical. This modernization that would contribute to the cultural value of fertility, was reversed by an economic meltdown that would create a shortage of health care services and thus accessibility. With the invasion of indigenous Zimbabweans donor funding not only saw a decline between 1990 and 2008, but the economic elevated the HIV crisis, thus decreased the international support to Zimbabwe for failure to obtain property rights and defaulting on loans. 530 Maternal deaths per hundred those live births became the ratio in 1990, 680 in 2000, and 470 in 2013. 18% of women of childbearing age (15-49) were living with HIV/AIDS. 26 % of all maternal deaths were due to this epidemic as well. In attempts to utilize the midwife traditions the pros and cons of the original practices were examined.
Cons of Traditional Midwifery
1. Lack of vaginal examinations can lead to late diagnosis of abnormal position of the fetus.
2. A belief in strong pushing could lead to pushing before the cervix is fully dilated.
3. Early traction to the umbilical cord can lead to detachment of the cord retaining the placenta.
Pros of Traditional Midwifery
1. Beliefs in strong pushing actually encourages squatting in order to push
2. Prolonged lactation can be used to promote contraception knowing that prolonged lactation was used as birth control traditionally.
3. Early traction on the umbilical cord can be an early indicator of postpartum hemorrhaging.
While the global acceptance of western practices allow the depiction of Zimbabwe traditional practices to be seen as an unsanitary or underprivileged midwifery, the reality of the rural areas being accommodated by traditional practices that are beneficial to greater population serve practically that would would seen as elites in other countries. The depiction of a dirty midwife practice due to the epidemics caused by lack of funding does not automatically make midwifery even in the practical sense the cause of the health epidemics. Despite the lack of political will and economic abundance, the cultural value of fertility is not hindered by midwifery, but is in fact manipulated to encourage the ideals of western medicine in all of it's "superiority."