Birth at the health center or at home: an analysis of birthing care among the Kukamas Kukamirias women of Peru

Objective: to describe and analyze the culture and traditions related to pregnancy, childbirth and postpartum care of the Kukama kukamiria women, living in the Peruvian Amazon, and their experiences and perceptions of care at home compared to that received at the health center. Methods: a qualitative study based on ethnography that seeks to analyze traditional knowledge and practices of self-care, taking into account descriptions of home births attended by traditional midwives, compared to that of birth care at the health institution. Results: home delivery prioritizes women’s’ comfort, through the use of teas, baths and specific rituals in caring for the placenta; dietary regulations and attention to environmental aspects such as temperature and lighting are built into care. At the health facilities, routine interventions include acceleration of labor with the use of drugs, vaginal cutting (episiotomy), immobilization in lithotomy position, and the disposal of the placenta as garbage; which is perceived as inadequate and aggressive. Conclusion: a preference for traditional care is justified based on feelings of neglect and vulnerability at institutionalized health centers, resulting from the lack of consideration by the health services for the cultural and well-being specificities of the Kukama Kukamiria women.