We often hear this term, “cultural competence” but what does it really mean to be culturally competent? What does this mean on an individual level and what does it mean in the area of maternal health? Well, let’s break down the meaning of culture and competence. According to Boston University, culture is defined by “all the ways of life including the arts, beliefs and institutions of a population passed down from generation to generation. Culture has been called “the way of life for an entire society.” “As such, it includes codes of conduct, dress, language, religion, rituals, art, standards of conduct, such as law and morality, and belief systems. (Boston University, 2016). A simpler definition and the one we are probably more familiar with can be found in Merriam-Webster’s Dictionary which reads; “the customary beliefs, social forms, and material characteristics of a racial, religious, or social group” too: “the characteristics of everyday existence (such as pastimes or ways of life) shared by the people of a place or time.” Again from Webster’s let’s look at the definition of reading ability; “having the necessary ability, knowledge, or skill to do something successfully.”
Based on these definitions, we know that culture is broad, it is complex, it can vary from generation to generation, person to person, family to family, it covers all the ways people move in life. With that in mind how much time and effort does it take to be culturally competent? How much time is required to “acquire the ability, knowledge or skills to work successfully with the customary beliefs, social forms, and material characteristics of a racial, religious, or social group; understanding the characteristics of everyday existence that people share in a place or time?” If we look at it from this perspective, I think we can understand that it takes some time.
Cultural competence begins with individuals first recognizing their own culture, beliefs, social norms. Think about what it is about your culture that you value, the language, the origin, the social norms, the food, the fun, the rituals and the traditions. Then think about the stereotypes associated with your particular culture, are you considered lazy, cheap, heavy drinking, unstable, or racist. What do these stereotypes mean to you? Have they caused you or your family pain, discomfort, loss of opportunities? Do they make you feel insecure, unsure or unsafe in certain spaces?
Now imagine that you are in the vulnerable place of pregnancy and you have to navigate the systems of care with the weight of responsibility of your culture, you want to keep your traditions, you want to take care of your family and new baby in your value on the front. The problem is that the systems you have to navigate are full of stereotypes that relate that you are your culture, people are blatantly biased and treat you indifferently and they don’t even know it. However you know it, you have a feeling in your gut that familiar voiceless pain. Maybe you can’t say it, but you can feel it deep in your being. Try now and have the best birthing experience possible! Is it possible to have the best birth experience without culturally competent providers and birth workers? If we don’t understand the importance of cultural competence, it’s impossible to give someone the best possible care.
Cultural competence is being aware enough not to be afraid to learn and honor the culture of others, learn their morals, values, belief systems and diseases. Realizing that understanding other people’s culture is inseparable from our own. Cultural competence isn’t just wearing a T-shirt that says I support the LGBTQIA+ community or putting a sign in your office that says “this is a safe place.” While these moves are common, they are not enough to combat the damage caused by implicit bias and incompetence at birth. You see cultural competence is an ethical standard. It is not only about our behavior but also about our beliefs in systems and frameworks. It is the ability to care enough to study and work in all or different cultures. It never gets old and we never reach its conclusion, cultural competence starts with awareness and with every client we serve from another culture our competence grows.
It is impossible to be culturally competent and not expose ourselves to other cultures. It is not just identifying a culture at a particular time of year or asking a particular group to explain their culture. Now there is room for curiosity but follow it with affirmation of empowerment and lifelong learning.
As a doula and doula trainer, we spend a lot of time talking about comfort measures, advocacy, interventions, pain management and birth plans. All of these concepts are great but a culturally incompetent provider, or doula no matter how many trainings we’ve taken or the information we have can ruin how a person experiences their birth. So consider this a call to action, an opportunity to rethink and reflect on our influence in the birthing community. Working on our cultural competency can make all the difference in how we approach clients. Because, unless we continue to learn about other cultures with intention, it is impossible to give someone the best possible care.
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About the Author
Karen M. Peterson owner of KMP Doula Service has over 30 years of experience working with women, children and families. She is a faculty doula trainer for CAPPA, a certified labor and certified postpartum Doula (CAPPA), a certified lactation counselor, a safe sleep ambassador, and a certified child passenger safety technician.
Karen believes that the place of birth is a sacred one and feels privileged to help birth people on their journey. Karen loves childbirth because it is a place where everyone involved becomes new. Karen supports healing, health equity, and the rights of pregnant women. Karen has great relationships with community-based organizations and is connected to many referral services. She is a wife, mother and grandmother with a blended family of 8 children and 13 grandchildren.
She holds a BSED from West Chester University and has taught at every grade level from K-12. Karen spent 12 years teaching pregnant women and teen parenting and before that she was a foster parent to teenage mothers. Karen is the former program director for Pettaway Pursuit Foundation’s Doula by My Side Program and former interim program manager for Daddy University’s Paternal Involvement Initiative and Doula 4 Dads Program. Karen is the former founder and executive director of the non-profit Women of Harmony, Inc.
Karen is currently the Healthy Start case management coordinator and supervisor for the Doula Supplement program under The Foundation for Delaware County. Karen is a member of the Delaware County Breastfeeding Coalition and is a graduate student at Widener University receiving a masters in clinical social work. Karen can be reached by phone or email at 610-809-1487 or kmpdoulaservice@gmail.com. Karen loves her family, teaching and self-care through travel, dining, swimming and yoga.
