Indigenous Women's Health Book, Within the Sacred Circle: Reproductive Rights, Environmental Health, Traditional Herbs and Remedies (review)

Balance as a Native American ideal is well achieved by the authors of Indigenous Women's Health Book, Within the Sacred Circle, who take on the ambitious goal of providing basic health information that is sensitive to the wide range of indigenous tribal cultures. Yet the manner and presentation garner the interest of a diverse audience. Political and social issues unique to tribal culture are considered with guidance for those seeking or advocating for quality health care. The text divides into four sections: "Our Changing Bodies," "Reproduction," "Taking Care of Ourselves, Our Families and Our Environment," and "As We Age." Each chapter includes referral and reference information.

In the chapter on contraceptives, information covers a realistic range of options like the female condom, emergency contraception, and menstrual extraction to name a few. Yet each section's organization allows the reader to weigh issues such as advantages, disadvantages, health risks and contraindications, cost, effectiveness, and who shouldn't use the method. The focus on personal choice permeates this chapter making it user friendly while equipping the reader with the tools needed to broach the subject effectively with health care providers and friends. Similarly, the chapter on abortion and sterilization candidly discusses options highlighting the issues that guide personal choice. Again, each section covers information that allows the reader to carefully consider wide-ranging options.

The chapter on exploration of sexuality is exquisite. In the beginning, a personal biography includes a touching note to the author's mother giving insight into the confusion and difficulties adolescents and young adults face with questions of sexuality. Another high point is the chapter on mental health that clearly explains complex issues and common misconceptions. The discussion on (dis)trust of Western medicine and doctors has a truly compelling story of a woman who reluctantly seeks Western medicine for her son's mental health problems. She ends by saying, "It was a year of hell for all of us, but I would do it again, because I feel like I have my son back" (214). Two other "must read" chapters deal with domestic violence and traditional herbs and remedies accenting profiles of traditional healers.

The authors do not shy away from political or new issues that will affect indigenous peoples. In particular, the chapter on the Human Genome Project lays out the reasons that some indigenous groups have opposed the Diversity Project. The chapter discusses the strategies that political groups are using to protect people, land, and culture. Although problems with precision farming, for example, need to be addressed by all peoples, the steps taken by indigenous groups reflect continuing commitments to protecting the future for all.

Texts such as this are excellent for providing overviews of conditions such as sexually transmitted diseases, diabetes, cancer, and others faced by women. Yet such summaries must leave out some details and often readers are left wanting more. For example, the discussion on breastfeeding could cover remedies for common problems that would help women to successfully breastfeed. The use of nipple shields and other suggestions are critical for some women in the early days of breastfeeding who may otherwise give up on this important practice. The chapter on menstruation could include issues of embarrassment and stigma and traditional approaches and practices that normalize cycling and help women who experience common problems. Such an expansion would be particularly important for young women and women facing menopause whose bodies no longer follow their past patterns. Because so many practices of indigenous Americans that give context and support to women are at risk of being lost, adding sections for ceremonies like welcoming new babies or having an elder discuss their experience with a first pregnancy would be vital for women seeking to enhance and practice their culture. And the chapter on substance abuse needs to highlight the programs developed by...