Being exposed to pregnant and laboring women has shown that how we respond to birth is cultural based. Our emotions about it and our perceptions of pain even.
Here in the philippines (and even in Jamaica) there is little emotional support nor do women doubt they can birth--it is expected if you are a woman and that your body will work. There is very very little noise made even in hard labor. They are very stoic and quiet even when pushing. but the reality of the risk of them or their baby dying is very very high and very real in the poorer areas. So many women who came to the clinic for prenatals have miscarriage or stillborns or deaths in early life--it is very common.
How a midwife approached the women and their pregnancy and labor is also cultural. Because the population is poor and generally malnourished or anemic their is more active management to the immediate birth and postpartum--this has proven to save many maternal lives as well as a decrease of infant deaths by 22% if babies are nursed in the FIRST HOUR!!!! and another 14% if nursed in the first 24 hours. Breastfeeding is the key to decreasing the infant mortality of the 3rd world countries. The issue is the people buying into not nursing right away cause they have no milk or using watered down formula.
Seeing the cultures and how different they are is eye opening and yet women birth the same and nurse the same and need physical and emotional support when issues come up.