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Course: Maternity Nursing�Topic: Cultural Beliefs and Pregnancy

The Nurses International Community

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Module Goals

The learner will be able to:

Define culture and its effect on the childbearing family
Identify cultural values, beliefs and traditions of pregnancy
Compare global cultural differences during pregnancy and childbirth
Identify the role of the maternity nurse in culturally diverse settings

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Defining Culture

According to Zimmermann, 2017

A group of people who share the same characteristics and knowledge about language, religion, food, social habits, music and arts

Cristina De Rossi (Anthropologist) states that culture determines our habits, food, religion, costume, language, marriage, art, music, belief system, wrong/right, how we behave, how we sit, how we greet and hundreds of things we do in our daily lives.

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Influence of Culture in our Lives

Most of the time, our belief system is guided by our culture
Culture shapes our attitude
It also shapes the way we behave during happiness, sadness and grief
Culture determines what to celebrate and how to celebrate
Culture shapes our various events in life (birth, death, pregnancy, illness, wellness)

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Culture and Pregnancy

Pregnancy is an exciting journey
Cultures vary in their views about pregnancy
Cultural background influences the needs and expectations of pregnancy and childbirth
Cultural “do’s and don’ts” are embedded in the pregnancy and childbirth experience

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What Would the Nurse Do?

The husband of a pregnant woman tells the midwife that “pregnant women should avoid consuming dairy products as it passes to the womb and attaches on the baby’s head.” He says he “ has witnessed a baby born full of milk products on the head…full of cream and cheesy substances” and says that “such babies die immediately after the delivery.”

What misconceptions might this statement represent?

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Cultural Taboos

Women from some cultures avoid certain kinds of food during pregnancy
In some cultures, it is believed that a woman should not move too much during labor (either sit, lie down, or squat)
Fathers (Southeast Asia) feel that it is not good to get involved in the birth process (woman’s business). Instead the mother or mother-in-law attends the birth

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Cultural Taboos

In some cultures, a new mother must stay in bed for several days following childbirth
In some rural communities of Nepal, women and their babies are not allowed in the sun for 11 days after delivery
Foods consumed cold/raw like fruits and vegetables are considered taboo among nursing Mexican mothers and believed to cause harm to the newborn

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What Would the Nurse Do?

A nurse leads a discussion about choice of delivery with a group of pregnant women. The nurse discovers that some women desire a cesarean section because women of higher class often deliver this way.

One woman states that she does not want to end up divorced, as normal delivery destroys the integrity of the genital tract and causes sexual problems in later life.

What would be the nurse’s response to these two statements?

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Examples of Cultural Differences Around the World:

Chinese:

May not talk about their problems easily
Social and cultural taboos exists
Health related beliefs exists
Views pregnancy as sickness
Dietary restrictions during pregnancy

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May not talk about their problems easily as they assume that others will not understand their problems. They may avoid saying “NO” as it is considered impolite in the culture.
Open discussion about sexuality is considered taboo. Women and men are not comfortable with the opposite gender so prefer same-sex care providers (especially women prefer female doctor or nurses)
Health-related beliefs: They believe that foods, illness, and medications are classified as hot and cold. Therefore, the imbalance between hot and cold causes illness. They have strong beliefs about ghosts, evil spirits, and their interference may lead to illness. They have strong beliefs and faith in the traditional mode of treatment i.e. acupuncture, acupressure, and some Chinese herbs. They also believe in dietary therapy and supernatural healing(God).
Chinese people view pregnancy as sickness and highly depend on others for assistance and care. That is why they might not be comfortable with modern nursing care as it encourages independence.
Dietary Restrictions and choices: They believe that the balance of hot and cold, should be fulfilled with the dietary components. Example: Prefer eating soups and broths, not eating lamb as it may cause epilepsy, restricting pineapple as it may cause miscarriage.

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Examples of Cultural Differences Around the World:

Indian:

Easily agreeable
Believe doctors will do everything
Ayurveda is widely practiced.
Sees pregnancy as normal phenomenon
Specific food preferences during pregnancy
Gender preferences (male)
No restriction on physical activities

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Will say yes to please the healthcare providers. Will not question if they do not understand the concept and treatment plan. Thus a healthcare provider should ensure that patient understands the concept clearly (ask them to summarize what you have said).
They believe doctors will do all care: including the history taking and thorough examination.
Ayurveda is widely practiced in India. However, the use of modern western medication and treatment is popular among the wealthy and educated.
Pregnancy is a normal phenomenon: pregnancy is viewed as a normal phenomenon and does not require medical interventions. Only in certain events or problems will they see the healthcare providers.
Foods are divided into cold and hot and have to be taken as per the phases of pregnancy. Pregnancy usually is considered a hot state, therefore cold food is preferred in early pregnancy, and warm and hot food are preferred in the late stage of pregnancy. Excessive eating may cause a large fetus and cause complications.
Gender preferences: people usually prefer a male child to a female and consume some herbs to have a male child.
There are no restrictions on physical activities during pregnancy, and people from low and middle income-oriented populations will continue to do their regular activities and without restrictions. However, modern and higher-class families will rest and are taken care of by their families.

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