Working with Native American Families During the Perinatal Stage and Early Childhood

  • Clara Aisenstein
  • Anna Rueda


This chapter discusses the diversity among many Native American tribes and the difficulty of generalizations. It describes, however, some common themes such as the history of displacement, cultural devaluation, ethnic segregation, and growing up in a reservation. It emphasizes the transgenerational effects the systematic taking over lands, extermination of tribal members, and the treatises that legalized the current status quo, including the Indian Health Service. There is a description of traditional practices such as swaddling, healing through natural remedies during pregnancy and early childhood, and resorting to “medicine men.” These practices coexist or supplement the medicalized modern system of provision of healthcare. Many tribes emphasize harmony with nature, respect for the individuality of children, and an approach to child-rearing that favors nonverbal interactions, implicit messages, storytelling, and teaching by example and observation. The problems in reservations such as poverty, segregation, alcoholism, and hopelessness are addressed, as well as the resilience of families who adapt family relationships and use kinship care to supplement the care of children who need it, extending the concept of family and a caregiving system. The communicational style may be different; avoiding eye contact, taking time to develop trust, and speaking in an oblique way about problems are described in contrast to the more businesslike approach that is commonly used in Westernized health systems. The effect of boarding schools and attempting to “acculturate” Native American children in previous generations is described as well as its transgenerational effects.


Indian reservation Native American tribes Cultural genocide Aboriginal cultures First nations Natural healing Healing ceremonies Medicine man Cradleboard Swaddling Alcohol fetal syndrome Transgenerational trauma Boarding schools 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Clara Aisenstein
    • 1
  • Anna Rueda
    • 2
  1. 1.Indian Health ServiceSan DiegoUSA
  2. 2.Department of Public Health and Primary Care PediatricsBaylor College of MedicineHoustonUSA

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