An Historical Perspective of Helping Practices Associated with Birth, Marriage and Death Among Chamorros in Guam (review)

The Pattera of Guam: Their Story and Legacy.25 minutes, VHS1/2 inch, 2001. A video documentary by Karen A Fury Cruz, Pattera Video Project, PO Box 24856, GMF, Barrigada, Guam 96921. US$15 plus shipping and handling.

This video documentary was made to honor the pattera, or midwives, of Guam. With the still photographs interspersed among interviews, the story is told of the critical role these women played in society, sadly followed by the negation of their knowledge and skill. The video starts at the beginning of the twentieth century with the shift from Spanish to American colonial rule and the adoption of a western biomedical approach to health care. In 1907 young Chamorro women were invited to study nursing at the US naval administration medical school. The training lasted two to three years, with several additional months needed for certification as a nurse midwife. The nurses worked in the hospitals and with the Red Cross, and the pattera functioned independently in the villages. From that time until the 1950s when their licenses were revoked, pattera attended virtually all the births on Guam, caring not only for the mother and newborn, but for the entire family. The story of the loss of this invaluable health care resource is made all the more poignant by the interviews with three elderly pattera, who reminisce on camera about their careers. These women exhibit great intelligence, dedication, compassion, and a sense of responsibility for the charge that was entrusted to them by the families who came for their help in the middle of the night.

The video is less than half an hour long yet manages to cover a great deal of material. One gets a sense of the home births by listening to the pattera talk of how they positioned the fetus, and the way they involved the whole family in the birth. They were well trained in the biomedical approach and knew when to refer a mother to the hospital if she was having complications, but they also were knowledgeable about Chamorro beliefs. Pattera understood the importance of burying the placenta under the house, and knew when to recommend herbal medicines for a mother or newborn.

One learns of the toll this work took on the pattera's own family. Because she usually stayed with the new mother for three days, the patterahad to rely on her extended family to care for her own children during that time. One adult man told that as a boy he enjoyed going with his mother when she made her visits because the families were so grateful to her, they treated him very nicely and gave him all sorts of good food to eat.

"And then the war came," as one woman put it simply, and things changed abruptly. During the Japanese occupation many villagers went to the hills, others to concentration camps. The pattera cared for the sick wherever they were, with whatever materials they had. Change came again in 1955 when the US government stopped renewing licenses for midwives and told them births must occur in the hospital in order to modernize medical care. The pattera were encouraged to avail themselves of refresher courses, but many felt threatened and declined. The last recorded home birth attended by a pattera was in 1967.

ThePattera ofGuam is a very well made record of midwifery in Guam and the intended and unintended consequences of western biomedical hegemony. It approaches the story of pattera with historic material and social commentary supported by personal narratives. The video is a nice companion to the book,An Historical Perspective of Helping PracticesAssociated with Birth, Marriage and Death among Chamorros in Guam, by Lilli Perez Iyechad. The video answers some of the questions raised by the book about who these pattera were, so clearly important in village life. It also contributes to Iyechad's analysis of reciprocity around the birth with comments made by the sons and daughters...