To give birth in the diaspora: The Intercultural Gestation Experience of Ngäbe and Bugle Women in Coto Brus, Costa Rica

Abstract

This article reflects on the intercultural experience of childbirth for indigenous women from the Ngäbe and Bugle community in Coto Brus, Costa Rica. It addresses the social, economic, cultural, and medical challenges these women face regarding pregnancy and childbirth care, emphasizing the diasporic nature of their experience. The article describes the context of Costa Rican cultural and ethnic diversity, as well as the specifics of the Ngäbe and Bugle community, their challenges in cross-border migration between Costa Rica and Panama, and the situations of exclusion and social and labor precariousness to which the community is forced. Special emphasis is placed on the community's spiritual notions and their vision of health in continuum with that cosmogony. The general context of maternal and childcare in the Costa Rican health system and the existing public policies on the subject are then described. In addition, the actions implemented by the State for the gynecological and obstetric care of this indigenous and cross-border migrant population are discussed, especially the rationale and purpose of the La Casona EBAIS.Finally, these actions are problematized from three perspectives: the Ngäbe and Bugle community as a diaspora resisting the cultural imposition of the State; the notion of cohabitation and interculturality that seeks a correlational configuration of health policy decision-making; and the critique of the Costa Rican state's notion of intercultural management of childbirth, in which the vertical and colonial notion of pregnancy and childbirth management persists. This is the starting point for offering the State opportunities for improvement that allow for respectful, relevant, and human rights-compliant medical care.