The life histories of traditional birth attendants in the context of changing reproductive health practices in uMzimkhulu, KwaZulu-Natal.

Abstract

This is a study of the life histories of Traditional Birth Attendants (TBAs) based in uMzimkhulu in the province of KwaZulu-Natal in South Africa. The study sought to explore the life histories of the TBAs, their practices, rituals and attitudes. It further investigates the attitudes of women who make use of their services and those who prefer not to. TBAs fall into the cultural realm of traditional medicine and offer traditional medicine and rituals to pregnant women. uMzimkhulu is small town in a rural area where the use of traditional medicine is popular, regardless of free access to western health care facilities. Culture still plays an important role in this community, and for successful pregnancies, many women in the community seek the services of TBAs. This study has found that traditional medicine plays a ‘silent role’ in the health care system as many pregnant women continue to seek traditional sources of health care; in the case of uMzimkhulu, many of the participants preferred to use medicines prepared by TBAs during their pregnancies. The study adopted a qualitative research design. The research techniques included in-depth interviews and participant observation techniques. Interactions with the TBAs took place at their homes which allowed the researcher first-hand experience of the relationship between TBAs and the women that seek their services. Other interactions took place in the homes of the participating women and at the Rietvlei hospital where the health care practitioners work. Three theoretical perspectives were adopted in this study: African feminist theory, social identity theory and the social capital theory. The life histories of the TBAs contributed to a rich understanding of reproductive health care from the perspective of TBAs, their attitudes and experiences. Furthermore, a better understanding was gained of the practices they offer and the cultural meanings attached by those who seek the services of TBAs. This study has demonstrated the important role culture plays in the lives of the participants. Cultural background influenced many decisions made by the pregnant participants with regard to their health seeking behaviour. Despite efforts of the western hegemonic health care system practitioners to discourage women from using alternative traditional medicines, many continue to use these with the view that western medicine does not fully protect their pregnancies.