Zac Leighn8318735Tutor: Judith Meiklejohn
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http://growinginashrinkingculture.wordpress.com/
Artefact Description
Culture has had a large effect on the way people portray and visualise their issues and pains. In the relation of child birth, the cartoon above shows the typical ‘Western’ woman’s reaction to a question about their pregnancy. The women has much rather responded with a positive remark and ‘keeping face’ that having a child is the greatest experience that validates her being a woman, when all she is thinking about is the pains and problems associated with pregnancy.
Public Health Issue
There has been much debate over the standard at which our Emergency Service Providers are you could say ‘Culturally Clued-In’ in relation to their patients and pain and as such will be studied in this analysis. More specifically the topic of Pregnancy will be discussed and the perception Western women have that they must maintain the identity that being pregnant is the ‘mark’ or defining aspect of their femininity (Hine, G. 2011). The media has had a large impact on this perception through such mediums as magazines, social media sites, television and fashion (Hine, G. 2011).
Literature Review
Research has shown that many women, especially those from minority backgrounds, gain sexual identity and worth from pregnancy and often continue with multiple pregnancies after (Reed, S. & Miller, R & Timm, T. 2011). This has been evident across many cultures and can be traced back to ancient times, more evidently in Middle Eastern cultures where it is acceptable for a man to have more than one wife. One of the earliest recordings of this psychological need for acceptance and worth, roots from the Christian Bible in the book of Genesis. A man named Jacob had who wives, Leah and Rachel. However, for the first period of their marriage, only Leah seems to be giving birth to children, causing Rachel use her maid as a vessel for a child. Over time, and now even in the media, pregnancy has become a clear validation of a woman’s identity and femininity. A study conducted by Sultan, S & Tahir, A. (2011) showed that infertile couples demonstrated higher levels of anxiety, aggression and depression. This shows that not only does a sense of worthlessness and loss of identity affect the female but also her partner, as much as people like to think that money can make you feel better, the same study showed that income had no effect on the psychological distress felt by these couples.
Objectification theory, in the context of women and pregnancy, argues that a woman’s body is an object that is to be evaluated by (Rubin, L & Steinberg, J. 2011). When it comes to pregnancy, it is a shared event that many women go through, thus the stereotypical evaluation of body size becomes secondary to the questioning about the baby and the feeling of pregnancy itself. It is for this reason, as the artefact above shows, women will rarely indulge people with the details of pains and issues associated, but rather foreground the information that coincides with the media oriented image of a ‘fairy tale’ pregnancy where everything is perfect and painless (Rubin, L & Steinberg, J. 2011).
A current trend on topic of pregnancy that seems to be similar across certain cultures is the fact that many women are childless for much of their child barring years, with their time spent in the workforce focused on career (Boucai, L & Karniol, R. 2008). This however is opposed in the Israeli community as the fertility rates in Jewish Israeli women are higher than even those in the Western world (Boucai, L & Karniol, R. 2008). Again, the use of child birth as a means of validation runs back into the cultural background of these people.
A study conducted by Messias, D & DeJoseph, J. (2008) showed that one major aspect involved in the ‘identity transformation’ of a woman during pregnancy is transition from a ‘woman’ to a mother. A somewhat maturity is developed over the nine months involved, that a woman’s identity is defined by the child she is carrying, anything she does, the baby is affect. Her life becomes the baby’s life and for this reason many women cease the consumption of alcohol and other such dietary substances. A woman’s ‘motherly/protective instincts’ develop and she wants to take care of her unborn child. The study Neugebauer, R., et al. (2006) indicated that, for women who have experienced either one or multiple miscarriages, the levels of sub-syndromal depression and suicide are raised significantly. This is due to the connection and protective instincts that have developed over the course of the pregnancy by the mother.
In relation to the job of emergency service providers, unless a woman feels she is in an environment of disclosure, she may not be entirely forthcoming with all the details of her pain when it comes to pregnancy. As the artefact above indicates, she may simples attempt to brush aside the pain she is feeling and say that she is ‘fine’. Cogan, R & Spinnato, J (1986) also showed that a woman’s pain threshold is increased during pregnancy, meaning that she can be unaware of certain pains. Something she would have considered painful prior to pregnancy could no longer feel so, and in turn cause a health risk and issue for emergency service providers as they would be unaware of potentially vital information. Also, as the patient may be unaware of certain pains, the emergency service provider should always keep an eye out for anything that could potentially be ‘out of the ordinary’ as this could provide a health risk to the mother and also the child.
An emergency service provider should never assume a patient is falsifying pain or symptoms, nor should they providing relief according to their own experience. Devi, B & Tang, T (2008) indicates that a patients pain should be considered a somewhat fifth vital sign, and therefore be regarded a valid response. This due to the fact that the patient is the only individual who knows what the pain they are going through in fact feels like.
Cultural/Social Analysis
As has been illustrated in the review above, not only does culture and society play a major role in the pregnancy of a woman, but also that woman’s self-image and the media. Objectification theory, in the context of women and pregnancy, argues that a woman’s body is an object that is to be evaluated by others (Rubin, L & Steinberg, J. 2011). Women will rarely indulge people with the details of pains and issues associated, but rather foreground the information that coincides with the media oriented image of a ‘fairy tale’ pregnancy where everything is perfect and painless (Rubin, L & Steinberg, J. 2011).
When comparing cultural views and beliefs on the topic of identity and pregnancy, there can often be a large diversity of responses. Many Middle Eastern cultures and family based cultures such as the Italians, Greeks and other European countries, it is considered normal for women to have multiple children, with families having in excess of ten members excluding grandparents and the extended family Italy (2011).
Patient backgrounds should always be taken into account as there can be major consequences when not. If an emergency service provider does not understand how a patient’s cultural background deals with pain, injury or suffering, the patient could end up receiving under or overtreatment. This can result in further injury or health risk to the patient if too much of a pain relief is given.
Emergency service providers are expected to always take a patient’s cultural background into their assessment and communication as this can and will reduce any confusion and miscommunication. Although a lot harder to interpret, if the emergency service provider knows at least a small amount of information about a pregnant patients cultural background, they would be more prepared to ask appropriate questions that will be answered with the most useful information as possible, and in the case of women who hold their image highly, communication should be held preferably in an environment that is away from other people as to maximise privacy and comfort for the patient.
Personal Reflection of Artefact
Much of what has been reviewed and discussed in the page above can be related back to the artefact at the top of the page. From the look of the pregnant woman, she is of western descent meaning that, as with all western people, she is influenced by the media. No matter how minute, everyone is influenced by the media. As has been discussed, when the elderly lady enquires about the baby and how the pregnancy is going, the pregnant lady simply responds with ‘fine’. Alone this would be a very simple and bland cartoon; however it is the thought bubble behind the pregnant woman that brings meaning to the cartoon. This shows all of the backgrounded information going on, all of the pain and negativity involved. However, as Objectification theory suggests, she doesn’t want to be evaluated negatively by the elderly lady and therefore does not inform her of the pain she is going through.
Being a male, I cannot say I have had personal experience being pregnant, nor do I think I will ever, however during the completion of this assignment I have begun to get a glimpse of what is ‘behind the curtain’ in relation to woman and pregnancy, and also the pressure placed on them by their surrounding culture. It would seem like it is enough to have to worry about what people think of you and how you look in general, but to continue to have that pressure applied when your body is going through phases that do not fit with the stereotype of an attractive woman, nor the body shape, it is obvious why many woman become closed-in and often experiences episodes of depression.

References
Boucai, L & Karniol, R. (2008) Suppressing and Priming the Motivation for Motherhood. Sex Roles, 59, 851-870. Doi: 10.1007/s11199-008-9489-0
Cogan, R & Spinnato, J (1986). Pain and Discomfort Thresholds in late pregnancy. Pain, 27(1), 63-68. Doi: 1016/0304-3959(86)90223-X
Devi, B & Tang, T (2008). Documenting pain as the fifth vital sign: a feasibility study in an oncology ward in Sarawak, Malaysia. Department of Radiotherapy and Oncology, 1(35), 9. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/18758195
Hine, G. (2011). Shaping Motherhood: Representations of Pregnancy in Popular Media. Otago University Research Archive, Retrieved from http://otago.ourarchive.ac.nz/handle/10523/1862
Italy. (2011). Countries and Their Cultures. Retrieved November 1, 2011 from http://www.everyculture.com/Ge-It/Italy.html
Messias, D & DeJoseph, J. (2008). The Personal Work of a First Pregnancy: Transforming Identities, Relationships, and Women's Work. Women & Health, 45(4), 41-64. Doi: 10.1300/J013v45n04_03
Neugebauer, R., Kline, J., Bleiberg, K., Baxi, L., Markowitz, J., Rosing, M., Levin, B., Keith, J. (2006). Preliminary open trial of interpersonal counseling for subsyndromal depression following miscarriage. Depression and Anxiety, 24(3), 219-222. Doi: 10.1002/da.20150
Radcliffe, P. (2011). Motherhood, Pregnancy, and the negotiation of Identity: The moral career of drug treatment. Social Science & Medicine, 72, 984-991. Doi: 10.1016/j.socscimed.2011.01.017
Reed, S. & Miller, R & Timm, T (2011). Identity and Agency: The Meaning and Value of Pregnancy for Young Black Lesbians. Psychology of Women Quarterly. Doi: 10.1177/0361684311417401
Rubin, L & Steinberg, J. (2011). Self-Objectification and Pregnancy: Are Body Functionality Dimensions Protective?. Sex Roles, 65, 606-618. Doi: 10.1007/s11199-011-9955-y
Sultan, S & Tahir, A. (2011). Psychological Consequences of Infertility. Hellenic Journal of Psychology, 8, 229-247. Retrieved from http://www.pseve.org/journal/UPLOAD/Soultan8b.pdf