Aziato et al.

BMC Pregnancy and Childbirth (2016) 16:138

DOI 10.1186/s12884-016-0920-1

RESEARCH ARTICLE Open Access

Religious beliefs and practices in pregnancy

and labour: an inductive qualitative study
among post-partum women in Ghana
Lydia Aziato1,2*, Philippa N. A. Odai1 and Cephas N. Omenyo1

Abstract
Background: Religiosity in health care delivery has attracted some attention in contemporary literature. The
religious beliefs and practices of patients play an important role in the recovery of the patient. Pregnant
women and women in labour exhibit their faith and use religious artefacts. This phenomenon is poorly
understood in Ghana. The study sought to investigate the religious beliefs and practices of post-partum
Ghanaian women.
Methods: A descriptive phenomenological study was conducted inductively involving 13 women who were
sampled purposively. Individual in-depth interviews were conducted in English, Ga, Twi and Ewe. The interviews
were audio-taped and transcribed. Concurrent analysis was done employing the principles of content analysis.
Ethical approval was obtained for the study and anonymity and confidentiality were ensured.
Results: Themes generated revealed religious beliefs and practices such as prayer, singing, thanksgiving at church,
fellowship and emotional support. Pastors’ spiritual interventions in pregnancy included prayer and revelations,
reversing negative dreams, laying of hands and anointing women. Also, traditional beliefs and practices were food
and water restrictions and tribal rituals. Religious artefacts used in pregnancy and labour were anointing oil, blessed
water, sticker, blessed white handkerchief, blessed sand, Bible and Rosary. Family influence and secrecy were
associated with the use of artefacts.
Conclusions: Religiosity should be a key component of training health care professionals so that they can
understand the religious needs of their clients and provide holistic care. We concluded that pregnant women and
women in labour should be supported to exercise their religious beliefs and practices.
Keywords: Spirituality, Phenomenology, Christianity, Prayer, Religious artefacts

Background [7, 8]. It is an integrated part of the total care provided

Religiosity and health are inter-related especially within to clients and their families in all spheres of nursing and
the African context where illnesses have been linked to midwifery [9, 10].
spiritual effects many years ago [1]. Witchcraft is associ- During pregnancy, women intensify their prayers to
ated with illness within the African context including is- God for protection, safe delivery and blessings [11].
sues of childbirth [2, 3]. Also, pregnancy and childbirth Some women panic at the mention of caesarian section
are associated with religious and traditional beliefs and for fear of death during surgery and others who undergo
practices in many countries [4–6]. In nursing and mid- caesarian section are stigmatized. This stigma transcends
wifery discourse, spirituality is an important component their generations [4]. Therefore, pregnant women would
of care and should not be relegated to the background explore all spiritual and traditional options to ensure
that they deliver spontaneously. Women commune with
* Correspondence: [email protected]; [email protected] their God either individually or in a group. The prayer
1
Department of Adult Health, School of Nursing, College of Health Sciences,
University of Ghana, Legon, Accra, Ghana
offered by pregnant women increases their faith and
2
College of Education, University of Ghana University of Ghana, Legon, Accra,
Ghana

© 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
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reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Aziato et al. BMC Pregnancy and Childbirth (2016) 16:138 Page 2 of 10

hope in God and it affords them the confidence of going post-partum women’s religious and traditional beliefs
through a safe delivery [11, 12]. and practices during pregnancy and labour.
The method of communication women use depends
on the specific religious group the woman belongs to. Methods
Women may use religious artefacts such as blessed Design
water and oil during prayers [13]. The blessed water and The study adopted a descriptive phenomenological ap-
anointing/blessed olive oil are ordinary water and olive proach to investigate religious beliefs and practices in preg-
oil that the religious leader prays over. These artefacts nancy and labour. An inductive approach was adopted to
may be used one-off or continuously for the duration of afford in-depth understanding of the phenomenon. A de-
the pregnancy [14]. It is believed that the Holy Spirit scriptive phenomenological study was considered appro-
(Spirit of God) uses the blessed water and oil as a priate for this study because it explores the personal
medium to impact on the user [13]. During prayers experiences of women and thus Ghanaian women’s specific
some women also recite verses of the bible [11]. Some religious beliefs and practices were revealed [28].
women also sing when communicating with their God
and this may be considered a nuisance to others who do
not use this form of communication with their God. Setting
Some religious denominations prescribe dressing mode Post-partum women were recruited from the Korle-Bu
for prayers especially at the place of congregation [15]. Teaching Hospital (KBTH). The participants were resi-
Others also remove their footwear before entering the dent in the Accra Metropolis and the hospital was a re-
prayer room. Religious restrictions pregnant women ob- cruitment outlet for the study. Accra is the capital city
serve depend on the groups they belong to. of Ghana and the KBTH is the first tertiary health facil-
The majority (71.2 %) of Ghanaians are Christians [16] ity in Ghana. The maternity unit of the hospital has a
and the Pentecostal/Charismatic churches are fast grow- post-natal clinic and potential participants were re-
ing churches in Ghana [17]. Within the Christian reli- cruited from this clinic.
gion are leaders who contribute to the spirituality of
women during pregnancy and labour. A growing Sampling and procedures of data collection
phenomenon in Ghana is religious Pentecostal/Charis- The study adopted a purposive sampling technique to
matic leaders praying for pregnant women and some recruit women who had delivered spontaneously within
giving the women religious artefacts such as anointing 2 months and were of the Christian faith. Women who
oil for their use. Some of these leaders also directly had caesarian sections were excluded because the wider
anoint the women and give them other spiritual direc- study from which this report was derived was focused
tions concerning the use of artefacts or the performance on labour pain. Women who go through caesarian sec-
of other specific activities aimed at safe delivery [18, 19]. tion may not go through labour pain before the surgery.
Previous researchers have reported several traditional Sample size was determined when no new finding was
beliefs and practices associated with pregnancy, labour generated (saturation). Saturation was achieved with 13
and the post-partum period. Some of these traditional women. Post-partum women were identified at the post-
beliefs and practices include food and water restrictions natal clinic. The place and the time of the interviews
[6, 20, 21]; avoiding specific places such as the graveyard were at the convenience of the women. After the study
[22]; not going out at specific times in the day [5]; not had been explained to the women, they were allowed to
associating with some people deemed to be evil [21] and make their own choices regarding participation. Those
drinking special herbal preparations [23]. Some women who consented to be part of the study were recruited.
are restricted from work during pregnancy while others None of the women approached in this study refused to
are not [24]. During labour, women suffer negative trad- participate. A semi-structured interview guide was used
itional beliefs that demand that they confess unfaithful- to collect all the data in this study. The interview guide
ness to their partners when labour is delayed especially was developed based on the objectives of the study and
for those who deliver at home [4]. Specific dietary re- probes were used to elicit further elaboration. Interviews
strictions such as avoidance of fish in diet may predis- were conducted in English, Twi, Ga and Ewe according
pose the pregnant woman to dietary deficiencies [20, to the participants’ preferences. Open-ended questions
25–27]. were asked to allow participants to express their
The literature so far confirms that spirituality cannot thoughts and probes were used to follow-up on partici-
be decoupled from pregnancy and child birth. However, pants’ comments and emerging themes. The first author
there is little attention on Ghanaian women’s experi- is experienced in qualitative interviewing and collected
ences of religious and traditional beliefs and practices in all the data. Individual interviews were audio-taped with
pregnancy and labour. This study sought to investigate a digital audio-recorder and later transcribed.
Aziato et al. BMC Pregnancy and Childbirth (2016) 16:138 Page 3 of 10

Data management and analysis comfortable during the interview. Mothers were allowed
Interviews conducted in English were transcribed verba- to cuddle their babies and breast feed during the inter-
tim and those conducted in Twi, Ga and Ewe were tran- view. Identification codes including PPW1 to PPW13 were
scribed in English based on the meaning derived. These assigned to the participants during data collection and
non-English transcripts were discussed with experts in these were used to present the findings. We ensured that
these languages to ensure that participants’ comments comments on specific religious beliefs and practices of
were accurately represented. The transcripts were checked women were treated with respect and confidentiality. Data
for accuracy and completeness by listening to the tapes were kept under lock and key and soft copy of data were
and comparing them to the transcripts. Concurrent data kept in a password protected computer.
analysis was undertaken in this study such that emerging
findings were followed in subsequent interviews. The Results
principles of content analysis were applied where tran- Demographic characteristics
scripts were read several times and coded. Similar codes The study involved 13 post-partum women who had de-
were grouped and re-grouped as the study progressed. livered per vagina within the last two months. They were
Groups and sub-groups were named as themes and sub- aged 18 to 35 years and were all Christians. With the ex-
themes according to the key findings [29]. Consistent with ception of one participant, all the women were married.
the tenets of phenomenology, the study held that know-
ledge is derived from the lived experiences of participants Description of themes and sub-themes
[28] and post-partum women have knowledge on their re- The themes were: Religious beliefs and practices (prayer,
ligious beliefs and practices. An inductive content analysis singing, thanksgiving at church, fellowship and emo-
was therefore appropriate for data analysis. The research tional support); Pastors’ spiritual interventions in preg-
team discussed the themes and sub-themes to ensure that nancy (prayer and revelations, reversing negative
the women’s worlds were fully captured. The NVivo soft- dreams, laying of hands and anointing women); Trad-
ware version 10 was used to manage the data. The first au- itional beliefs and practices (food and water restrictions,
thor did the initial data analysis and the other co-authors tribal rituals); Religious artefacts used in pregnancy and
coded independently and the themes and sub-themes labour (anointing oil, sticker, blessed water, blessed white
were compared. Discrepancies in coding and theme devel- handkerchief, blessed sand, Bible and Rosary); family in-
opment were discussed and a consensus was reached that fluence and secrecy.
best suited the data generated. Laying of hands involves the physical touch of pastors
on women during prayer and in the process, they may
Trustworthiness anoint the women by applying anointing oil or blessed
Strategies adopted to ensure trustworthiness of this olive oil mostly on the head or forehead.
study included the use of the same interview guide and
also one interviewer conducting all the interviews. Audit Religious beliefs and practices
trail was kept for other researchers to verify the pro- This theme describes sub-themes such as prayer, singing,
cesses undertaken in this study. Verbatim quotes of par- thanksgiving at church, fellowship and emotional sup-
ticipants’ comments were given to support the findings port during pregnancy and labour.
to allow for transferability of the findings in similar con-
texts. In-depth interviews allowed full exploration of re- Prayer
ligious beliefs and practices in pregnancy and labour. The women in this study had a number of beliefs asso-
Concurrent data analysis ensured that participants’ com- ciated with pregnancy and delivery. The central belief
ments were cross-checked in subsequent interviews and was the likelihood of a negative outcome of pregnancy.
emerging themes were followed through member- Therefore, the women prayed to prevent any complica-
checking. These approaches ensured validation of find- tions. They were of the view that pregnant women
ings as the study progressed. should be cautious as extra forces or evil spirits come to
play during pregnancy. It was emphasized that pregnant
Ethical considerations women should pray.
Ethical clearance was obtained from the Noguchi Me-
morial Institute of Medical Research at the University of ‘I know some pregnant women who did not pray or did
Ghana. Informed consent was obtained from each par- anything spiritual; so, when they went to the labour
ticipant. Participants were given the option to withdraw ward, they came back alone and some died. Therefore,
from the study at any time. We ensured that no partici- when you are pregnant, there are some extra forces
pant was stressed with provision of comfortable environ- that fight you in the spirit, and as such, you need to be
ment during the study and the babies of mothers were cautious; extra cautious!’ (PPW8)
Aziato et al. BMC Pregnancy and Childbirth (2016) 16:138 Page 4 of 10

The women prayed believing that God will help them programme at Church, I usually went and when they
go through labour successfully and minimize their pain asked us to pray, I prayed about my safe delivery
because the pain was unbearable. In those instances, the without anybody praying for me’. (PPW3)
thoughts and concerns about the baby were not para-
mount. Some of the women prayed to God because they Singing
were not sure of their survival during labour. In addition to the prayer, some of the women sang
quietly during labour and were asked by the midwives
‘I was praying, at a point I just said God should bring to keep quiet as they disturbed other women. During
out the baby and I will live; because, I didn’t know the singing, some women were thinking about the se-
whether I will be able to survive the labour because vere pain associated with the labour rather the un-
the pain was very severe’. (PPW12) born baby.

In addition, women prayed to God so they could deliver ‘a midwife warned me that I am not the only one on
peacefully. ‘I prayed when I was at the hospital that God the ward; that I was making noise because I used to
should be with me to enable me deliver in peace’ (PPW7). sing when praying; that was what I think made the
Also, prayer for women was done to ensure the protection noise’. (PPW4)
from the blood of Jesus against accident or tragedy caused
by the devil. The blood of Jesus was believed to be a potent
protector although it was not seen physically. ‘…the pastors
pray that the blood of Jesus should prevent all actions of the ‘I tell God it is not by my strength but His; so, He
devil and when the time is right everyone should deliver should help me deliver safely. And I also sang quietly.
safely; whatever tragedy or accident, God should prevent it’ …during the singing, I was thinking about the pain
(PPW2). Pregnant women also prayed that God takes con- and how God was going to save me. …the pain was
trol of their delivery process when labour starts. the first thing on my mind; I wanted the pain to
reduce because it was unbearable. So at that time,
‘I prayed to God to take away the human nature of seriously, I did not think much about the baby’.
the doctors and the nurses and to take absolute (PPW8)
control over the whole delivery process’. (PPW7)
Thanksgiving at church
Women in labour prayed that God will relieve them of Following the thanksgiving at the labour ward, most of
severe labour pain. ‘I prayed that God should free me the women went to church to give testimonies for their
from the severe pain I was going through’. (PPW12) safe delivery. ‘I went to give a testimony in church after
Some of the women who were initially scheduled my safe delivery’ (PPW2).
for a caesarian section prayed for a normal delivery The women were either prayed for in the church or
and they believed God answered their prayers when their family members prayed for them. Some of the
they did not undergo the surgery. The health care women received instructions from those who prayed for
providers were surprised that they were delivered of them to ensure their safe pregnancy and delivery. There-
their babies spontaneously. fore the thanksgiving at church showed appreciation for
the spiritual help received.
‘I was just thanking God and telling Him that He has
done what I wanted for me. I was able to give birth ‘…the pastors urged the rest of the congregation to
myself without an operation. So when I was leaving assist us (pregnant women) in prayers for safe
the labour ward, the doctors and midwives were all delivery’. (PPW8); ‘…in my church, they call the
surprised and even the doctor passed a comment that pregnant women to the front to pray for them during
“Eii, someone that we were going to operate upon and church service. So I went to church to thank God and
in less than 30 minutes you have delivered safely” he all those who helped me in prayer’. (PPW2)
was so surprised’. (PPW3)

Some of the women prayed for themselves during

pregnancy for safe delivery. The personal prayers were ‘…my sister was in a prayer force and they were
done at home or in the church. praying for me. … so if I had to go somewhere, she told
me to anoint yourself (apply blessed olive oil on the
‘At times I wake up at dawn and before bed time and body) and I did. After the delivery, I went to church to
worship God on my own. (PPW4); ‘when we had a God and the prayer force’. (PPW8)
Aziato et al. BMC Pregnancy and Childbirth (2016) 16:138 Page 5 of 10

Fellowship and emotional support Reversing negative dreams

Some of the women felt that it was consoling or reassur- Other women had bad dreams during pregnancy and
ing to know that others are praying during pregnancy. the pastors prayed with them even in the night. The pas-
This consolation is enhanced if it is accompanied with tors sometimes prayed in tongues (using different and
personal relationship with the pregnant women espe- unfamiliar language that is believed to be a gift of the
cially those having challenges with their pregnancies. In Holy Spirit). The prayers were aimed at averting any
this instance, a participant was angry with her church negative consequences on the pregnancy.
when they did not show the needed concern during
pregnancy. ‘I had a dream that I had been delivered of my baby
in the 7th month and someone took the baby away
‘It’s consoling that somebody is praying for you, from me. … I told my pastor about the dream and he
somebody is thinking about you and checking on you, I prayed for me. …he used to call me in the night; at
think it is really necessary. I was angry with my times 12 midnight, 2 or 3 am to pray for me because
church when they didn’t check on me; they did not give he said that was when the witches are active. He
me any attention when I was having challenges with prayed in tongues and I responded Amen! He said he
my pregnancy; I thought they had deserted me and I saw in a vision that there was a plan to terminate my
was not happy’. (PPW12) pregnancy so he prayed to prevent it’. (PPW4)

Pastors’ spiritual intervention in pregnancy Laying of hands and anointing women

This theme describes the interventions received from In the quest to pray for the women for one reason or an-
pastors during pregnancy. Sub-themes such as prayer other, some pastors laid hands on the abdomen and ap-
and revelations, reversing negative dreams, laying of plied blessed olive oil or anointing oil on it.
hands and anointing women are described.
‘The pastor asked me to lie down and he prayed for
Prayer and revelations me and I used a cloth to wrap my lower abdomen and
Most of the women sought prayer support from pastors my abdomen was exposed. Then, he used the
during pregnancy. The men of God had revelations anointing oil on it. …since people were in the church,
about the pregnancy and prayed for the women. Some they were also praying and he poured some anointing
of these revelations related to witchcraft that aimed at a oil in his hands and placed it on my abdomen and
negative outcome of pregnancy. prayed’. (PPW6)

‘…the pastor said that someone from my paternal In one instance, the pastor’s revelation showed that
family wanted to give my child witchcraft so he prayed there was nothing wrong spiritually with the pregnancy.
for me and sometimes when he saw any vision about ‘…the pastor said there was nothing wrong’ (PPW2).
me, he called me and prayed for me as the church However, a few of the women did not go to any pastor
members also prayed for me. He saw in a vision that for prayers. ‘…I never went to a pastor to pray for me
the witches had planned to terminate my pregnancy so when I was pregnant’. (PPW3).
the pastor prayed to prevent it’ (PPW6)
Traditional beliefs and practices
In other circumstances, pastors were consulted This theme describes the traditional beliefs and practices
when women could not feel foetal movements. The women observed or undertook during pregnancy. Sub-
pastors in such situations revealed that the baby was themes of food and water restrictions and tribal rituals
tied in the womb after a hospital assessment showed emerged. Women who reported traditional practices also
a big baby. In addition to the prayers, a specific bible went to church in addition to the traditional practices.
quotation was given to the women to use during
prayers. Food and water restrictions
Some traditional beliefs associated with pregnancy were
‘…at 7 months I could not feel my baby move so when that, pregnant women should not eat or drink in public
I went to the hospital and they said the baby was big to avoid effects of evil spirits.
that was why; so, I went to see my pastor and he
prayed for me and told me that the baby had been ‘I was told not to eat or drink in public to avoid evil
tied up in my stomach’. He gave me a quotation that I eyes; that was a traditional belief my mother told me
should use to pray. …I cannot remember the so I was following it.…I wasn’t eating in public and I
quotation’. (PPW2) didn’t eat any food cooked by somebody; Apart from
Aziato et al. BMC Pregnancy and Childbirth (2016) 16:138 Page 6 of 10

the one I cooked myself or maybe my mother or (tummy) or sometimes from my head to my feet or my
somebody closer to me cooked, I didn’t eat from any feet alone’. (PPW8)
other source; even those on sale. (PPW12).
Some of the women used anointing oil that was
Tribal rituals blessed by their pastors to prevent maternal and neo-
A participant described vividly a traditional practice for natal death. The use of the anointing oil was not regular
first pregnancy that was mandatory for her tribe. She because of lack of faith in it
was camped for 3 days, tied, bathed with urine, and
asked to buy shallots at dawn without talking to anyone. ‘The pastor said I should use the anointing oil to
This ritual was necessary to ensure ancestral protection, smear my abdomen and that will ensure my normal
a safe delivery and a normal baby. delivery; if not, I will die with my baby. …though I
didn’t believe in it, my husband did, so I did it for
‘…a few days to my delivery, I was camped in a room some time and I asked myself “what is the use of
for 3 days. During the period, I was tied with ropes this?”. So, I stopped’. (PPW12)
and bathed with urine. On the third day, they brought
me out early in the morning around 5:30 am and said Some women were asked to add the anointing oil to
I had to go and buy some small onions (shallots) and I their bathing water and use it for bathing.
was warned not to talk to anyone on my way. They
gave me 3Gh Cedis in coins. Also, they said when I get ‘The pastor said I should pour some of the oil in the
to the market, I should not ask any questions; I should water I use to bath and then bath with it. I did it for
just put the money down and take the shallots; so, I about a week and I didn’t see any use of it, so I
did that and I returned and they said the onions were stopped’. (PPW12)
to be used immediately after I give birth. So, when I
gave birth, they used it to prepare food for me the next Sticker
morning. It is believed that if a woman does not do the Women used stickers of pastors and churches during
ritual, the child will be abnormal. It is a traditional pregnancy and labour. Some women placed the sticker
ritual that had been there for a long time …it is done in the hair net they used to cover their hair on the
for only the woman’s first pregnancy. …when they were labour ward while others rubbed it on the abdomen.
doing it they called on the gods that if I have wronged Some women also placed the stickers in bottles of water
anyone or someone has anything against me, my fore they drank.
fathers or ancestors should intervene so that nothing
bad happens to me. The ceremony was done by older ‘a friend in labour had a sticker of her pastor in her
women in my tribe’. (PPW6) hair net and after bathing, she would rub her belly
with the sticker for a while and would then start
Religious artefacts used in pregnancy and labour smearing the anointing oil on her belly. …she also put
A number of religious artefacts were used by women to one in bottled water and was drinking on the ward; I
enhance their protection and ensure safe delivery. This told her that the use of stickers alone without prayers
theme describes the religious artefacts women used in cannot give her the desired spiritual protection’.
pregnancy and labour such as anointing oil, blessed (PPW8)
water, blessed white handkerchief, blessed sand, Bible
and Rosary. Blessed water
Most women in this study used blessed water (water
Anointing oil which had been prayed over by their pastors) as a reli-
Some women prayed over olive oil or anointing oil gious artefact. The blessed water was sometimes used to
themselves and anointed themselves. The areas of the wash the face. ‘I used the blessed water to wash my face
body anointed included the forehead, head, abdomen for a while and stopped’ (PPW13). Some women did not
and feet. The word of God was added during the prayer drink any ordinary water which may be bottled or in a
over the oil perhaps to increase its potency. sachet unless they had been blessed or prayed over by
their pastors.
‘I just prayed over the anointing oil, believing that it
works. I know that the anointing breaks the yoke of the ‘I remember my first pregnancy, I wasn’t taking
devil; I have that faith. So sometimes I open the bible ordinary water, I bought a box of mineral water and
to support the anointing with a verse and I just anoint we prayed over it before I drank it. I wasn’t allowed to
myself. …I apply it on my forehead and on my baby take in any other water; …even if I was thirsty and
Aziato et al. BMC Pregnancy and Childbirth (2016) 16:138 Page 7 of 10

you gave me water because my water was finished, I gave me anointing oil that he had prayed over. When I
won’t drink it. I went home and took mine’ (PPW12) wake up in the morning, I just apply some of the oil on
my abdomen, before I go out and even on my forehead
Blessed white handkerchief just to protect me; that was my belief. When I was
In addition, pregnant women were also given blessed going to the labour ward, I did not take the anointing
white handkerchiefs to be placed under their pillows for oil with me because that time my mind was on the
protection. Some of the artefacts were used under the pain and I forgot’. (PPW9)
influence of mothers. Some husbands however were not
aware of such artefacts. In another instance, the woman applied the anointing
oil on the abdomen to please the husband and did not
‘I also used a white handkerchief under my pillow; the use it when she was alone. ‘I wasn’t staying with my hus-
pastor prayed over it and gave it to me to place under band; so, when I went to his place, I tried to use the
my pillow for protection’. (PPW13) anointing oil but when I got to my station, I forgot about
it’. (PPW11)
Blessed sand
A woman reported using sand that was blessed by the ‘My husband never saw me use the blessed white
pastor and the woman believed that it was safe to use. handkerchief; …and I used the blessed water because I
Water was added to the blessed sand and the solution didn’t want to disobey my mother’. (PPW13)
was sieved and used for enema during pregnancy.
A framework that describes the themes is presented in
‘The pastor blessed sand for me; he prayed over it for Fig. 1: Religious beliefs and practices in pregnancy and
me to use …I had faith in it that when I use it, nothing labour.
will happen to me and it will work as the pastor said.
He asked me to add water to the sand, sieve it and use Discussion
it as enema from time to time and I did’. (PPW2) This study investigated the beliefs and practices of
Ghanaian women during pregnancy and labour with a
Bible and rosary focus on Christian women. A detailed insight was gained
Some women used the Bible and rosary to pray during which showed that Ghanaian women prayed alone, in a
pregnancy. A few women did not believe in pastors group, and were prayed for either by family members or
praying for them. These artefacts were believed to pro- their religious leaders. Prayer was sometimes associated
vide protection for the pregnant woman. ‘I used just the with singing and reciting the word of God. Women felt
Bible to pray; … I don’t believe in going to pastors to pray that group prayer and fellowship among members was
for me’ (PPW12). ‘…I used the rosary to pray; I had the reassuring and at the end of a safe delivery, women gave
rosary on my neck, I slept with it; I had the scapular too testimonies and thanks to God at Church. It was re-
for protection’ (PPW11); ‘I usually used my rosary to vealed that pastors prayed for women and provided
pray’ (PPW13). some revelations that were directed at interventions for
safe delivery. Pastors also prayed to reverse negative
Family influence and secrecy dreams, they laid hands on women and anointed them.
Some pregnant women used anointing oil as a result of A few of the participants reported their traditional be-
influence from their mothers although their husbands liefs and practices such as food and water restrictions
did not approve of such religious artefacts. A husband and tribal rituals invoked extra protection from ances-
instructed that the woman should not allow the pastor tors. An in-depth understanding of religious artefacts
lay hands on the abdomen during prayers. However, the used in pregnancy and labour was gained. Women used
woman on her own accord used the anointing oil on the
abdomen in the morning, when going out and on the
forehead for protection. The anointing oil was not sent
to the labour ward because of the pain.

‘My mum took me to a fellowship she worships with.

My husband hates it when someone prays for you. He
believes that you can pray for yourself and you will be
saved because you do not know what power the pastor
is using. So, when I went, he told me not to allow
Fig. 1 Religious beliefs and practices in pregnancy and labour
anybody to put the hand on my abdomen. The pastor
Aziato et al. BMC Pregnancy and Childbirth (2016) 16:138 Page 8 of 10

anointing oil, blessed water, blessed white handkerchief, Pastors also anointed the abdomen of pregnant women
blessed sand, Bible and Rosary. Family members influ- by laying hands on the abdomen during prayers. The ex-
enced some women to go for prayers and use religious posure of the abdomen in this study suggests that during
artefacts during pregnancy and some used the artefacts prayer sessions where a part of the body is exposed,
secretly. privacy should be ensured. Pastors praying for pregnant
This study used a descriptive phenomenological ap- women have been reported by previous researchers [12].
proach that employed individual in-depth interviews to The few women who reported traditional beliefs and
achieve a wealth of understanding on religious beliefs practices such as not eating or not drinking outside the
and practices in labour and pregnancy. Although the home supports previous studies and suggests that such
qualitative approach generated a deep insight into the restrictions may contribute to negative consequences for
phenomenon under study, the recruitment of only 13 the woman and the unborn child [20, 26]. Tribal trad-
women from an urban community who were Christians itional practices for pregnant women that involve poor
pre-supposes that the findings cannot be generalized to hygienic practices such as bathing the woman with urine
all pregnant women in Ghana. Perhaps rural women and may pose challenges for the woman. It implies that al-
those in other religious sets would have different experi- though ancestral protection is desired, the health and
ences. However, verbatim quotations provided in this well-being of women should be taken into consideration
study would enhance application of findings to women during such rituals.
with similar backgrounds. Religious artefacts used in this study included anoint-
The finding in this study that women prayed for God ing oil, sticker, blessed water, blessed white handkerchief,
to ensure a successful delivery and prevent misfortunes blessed sand, Bible and Rosary. Praying over the anoint-
or activities of evil spirits that affect the outcome of ing oil indicated dimensions such as self-prayer over the
pregnancy suggests that women had faith in God. This olive oil, pastors’ prayers and a family member praying
assertion is supported by previous studies [30]. Women over the olive oil before use. The anointing oil was ap-
in this study implored the blood of Jesus on themselves plied on different parts of the body such as the abdo-
to protect them from evil forces. The blood of Jesus is men, the forehead, the feet and the entire body. The
considered powerful and could prevent evil forces [31]. belief that the anointing breaks the yoke of the devil
The prayer for God to take away the human nature of meant that the anointing could destroy any negative in-
doctors and midwives suggests that women in this study fluence of the devil. This finding is consistent with exist-
believed that God can influence the doctors and mid- ing literature that indicates that the Holy Spirit works
wives. The women also believed God could reduce through the anointing oil [13]. The use of stickers of
labour pain when they prayed. It is important for health pastors or churches is a growing phenomenon in Ghana.
professionals to ensure adequate labour pain manage- However, women who add the sticker to their drinking
ment so that the prayers of women can be answered. water predispose themselves to health challenges as che-
Praying in a group, individually and at different times of micals used to prepare the sticker could dissolve in the
the day and singing and reciting the word of God [11] water. The use of blessed sand may also predispose
during prayers are characteristic of the Christian religion women to worm infestations; thus, women should be
especially those of the Pentecostal/Charismatic denomi- cautious as they practice their faith. The use of blessed
nations in Ghana. Fellowship among prayer group mem- water has been reported by other researchers [13] and
bers was reported as reassuring and emotionally safe water is recommended for this purpose. Using
comforting [11, 19]. This suggests that religious groups blessed white handkerchief for protection appears to be
should endeavour to give emotional support to pregnant an additional finding in this study although the Bible
women to enhance their mental state. and Rosary have been used by women elsewhere [32].
Most women in this study received prayer support The findings suggest that pregnant women deal with a
from their pastors. The pastors gave some revelations lot of voices such as those of their pastors, mothers, hus-
that bothered around witchcraft and the condition of the bands and health professionals. The fear of negative out-
baby and they prayed against any negative effect on the come of pregnancy and caesarian section compound the
outcome of the pregnancy. Pastors prayed to reverse problem. Women then engage in religious practices to
negative dreams and some prayed with women at night guarantee extra protection during pregnancy. In this re-
such as 2–3 am on phone. Praying with pregnant gard, midwives and gynaecologists should understand that
women late at night may disturb their sleep and also spirituality is an integral component of the care of preg-
contribute to conflict in their marriages if the spouses nant women in Ghana and they should encourage and
are also disturbed. In this light, although women would educate women to avoid the religious practices that could
go to all lengths to ensure a safe delivery, there must be have negative health effects on them and the foetus. Indi-
discretion when such prayer interventions are done. viduality and right of choice should be ensured so that
Aziato et al. BMC Pregnancy and Childbirth (2016) 16:138 Page 9 of 10

women would be allowed to demonstrate their religious Received: 15 December 2015 Accepted: 25 May 2016
beliefs and practices. This will ensure that the
phenomenon of secrecy with the use of religious artefacts
would be minimized. References
Further studies could explore views of pastors who pray 1. Badoe EA. A brief history of surgery. In: Badoe EA, Archampong EQ, da
Rocha-Afodu JT, editors. Principles and practice of surgery including
for pregnant women and those in labour to further under-
pathology in the tropics. Tema: Ghana Publishing Corp; 2009. p. 1–11.
stand the phenomenon under investigation. Perspectives 2. Assimeng M. Religion and social change in West Africa: an introduction to
of husbands and mothers can also be explored as well as the sociology of religion. Accra: Ghana Universities Press; 1989.
those of women from other religious groups and rural 3. Nukunya GK. Tradition and change: an introduction to sociology. 2nd ed.
Accra: Ghana Universities Press; 2003.
areas to triangulate the findings in this study. The views of 4. Okafor CB. Folklore linked to pregnancy and birth in Nigeria. West J Nurs
midwives and other health professionals who care for Res. 2000;22(2):189–202.
pregnant women could also be explored in future studies. 5. Ha W, Salama P, Gwavuya S, Kanjala C. Is religion the forgotten variable in
maternal and child health? Evidence from Zimbabwe. Soc Sci Med.
2014;118:80–8.
Conclusion 6. Elter PT, Kennedy HP, Chesla CA, Yimyam S. Spiritual healing practices among
rural postpartum Thai women. Transcult Nurs Soc. 2016;27(3):249-255.
Pregnancy and delivery have a strong religious connota- 7. Crowther S, Hall J. Spirituality and spiritual care in and around childbirth.
tion where a new life is born. The findings of this study Women Birth. 2015;28(2):173–8.
give an in-depth insight into the religious beliefs and prac- 8. Lewinson LP, McSherry W, Kevern P. Spirituality in pre-registration nurse
education and practice: a review of the literature. Nurse Educ Today.
tices of women that suggest that some of the religious
2015;35(6):806–14.
practices such as use of blessed sand and adding sticker to 9. Nardi D, Rooda L. Spirituality-based nursing practice by nursing students: an
water could have negative effects. The secret use of reli- exploratory study. J Prof Nurs. 2011;27(4):255–63.
10. Tiew LH, Creedy DK, Chan MF. Student nurses’ perspectives of spirituality
gious artefacts pre-supposes that some women do not
and spiritual care. Nurse Educ Today. 2013;33(6):574–9.
have the freedom to openly exercise their religious beliefs 11. Jesse DE, Schoneboom C, Blanchard A. The effect of faith or spirituality in
and practices even at home. Therefore women should be pregnancy: a content analysis. J Holist Nurs. 2007;25(3):151–8. discussion 159.
supported in their religious practices. Pastors who pray for 12. Liamputtong P, Yimyam S, Parisunyakul S, Baosoung C, Sansiriphun N.
Traditional beliefs about pregnancy and child birth among women from
pregnant women should be sensitive to their peculiar Chiang Mai, Northern Thailand. Midwifery. 2005;21(2):139–53.
needs and context and revelations given to women should 13. Fouka G, Plakas S, Taket A, Boudioni M, Dandoulakis M. Health-related
not lead to complications during pregnancy and labour. religious rituals of the Greek Orthodox Church: their uptake and meanings. J
Nurs Manag. 2012;20(8):1058–68.
14. Alling FA. The healing effects of belief in medical practices and spirituality.
Abbreviation Explore. 2015;11(4):273–80.
KBTH, Korle-Bu Teaching Hospital 15. Griffith EEH, Young JL. Therapeutic dimensions of sacred garments worn by
the Barbados Spiritual Baptists. Ment Health Relig Cult. 2013;17(3):313–26.
Acknowledgement 16. Ghana Statistical Service. 2010 Population and Housing Census: National
We thank Daniela, Kafui, Foster and John for transcribing the interviews. Our Analytical Report. 2013.
sincere thanks goes to Belinda Osei-Akoto for editing the manuscript. 17. Asamoah-Gyadu K. African Pentecostal/Charismatic Christianity: an overview.
2014. Retrived from http://www.lausanneworldpulse.com/themedarticles-
Funding php/464/08-2006. Accessed Dec 2015.
Funding was provided by the University of Ghana Faculty Research Fund 18. Ahmadi Z. Positive experiences of childbirth: a phenomenological study. 2013.
from the Office of Research, Innovation and Development office (Award # 19. Hoga LAK, Rodolpho JRC, de Souza Penteado PE, Borges ALV, Chávez
URF/8/ILG-052/2014-2015) as part of a wider on-going study. Alvarez RE. Religiosity and sexuality: counseling provided by Brazilian
Protestant pastors. Sex Reprod Healthc. 2013;4(2):57–63.
20. Oni OA, Tukur J. Identifying pregnant women who would adhere to food
Availability of data and materials
taboos in a rural community: a community-based study. Afr J Reprod
The transcripts from which this manuscript was developed are available on
Health. 2012;16(3):68–76.
request from the corresponding author.
21. Heidari T, Ziaei S, Ahmadi F, Mohammadi E, Hall J. Maternal experiences of
their unborn Child’s spiritual care: patterns of abstinence in Iran. J Holist
Authors’ contribution Nurs. 2015;33(2):146–58. quiz 159–160.
LA and CNO conceived the idea and wrote the proposal for the study. LA 22. Choudhury N, Ahmed S. Maternal care practices among the ultra poor
collected the data, LA, PNAO and CNO analyzed the data. LA drafted the households in rural Bangladesh: a qualitative exploratory study. BMC
manuscript and PNAO and CNO reviewed the manuscript. All authors read Pregnancy Childbirth. 2011;11(1):15.
and approved the final manuscript. 23. Lamxay V, de Boer HJ, Björk L. Traditions and plant use during pregnancy,
childbirth and postpartum recovery by the Kry ethnic group in Lao PDR. J
Competing interest Ethnobiol Ethnomed. 2011;7:14–4.
The authors declare that they have no competing interests. 24. Naser E, Mackey S, Arthur D, Klainin-Yobas P, Chen H, Creedy DK. An
exploratory study of traditional birthing practices of Chinese, Malay and
Consent to publish Indian women in Singapore. Midwifery. 2012;28(6):e865–71.
The participants gave consent for the findings of the study to be published. 25. Shannon K, Mahmud Z, Asfia A, Ali M. The social and environmental factors
underlying maternal malnutrition in rural Bangladesh: implications for
Ethics approval and consent to participate reproductive health and nutrition programs. Health Care Women Int. 2008;
Ethical clearance for the wider study from which this paper is drawn was 29(8):826–40.
obtained from the Noguchi Memorial Institute of Medical Research at the 26. Sharifah Zahhura SA, Nilan P, Germov J. Food restrictions during pregnancy
University of Ghana (NMIMR-IRB CPN 039/14-15). Participants gave informed among Indigenous Temiar women in peninsular Malaysia. Malays J Nutr.
consent to participate in this study by signing the consent form. 2012;18(2):243–53.
Aziato et al. BMC Pregnancy and Childbirth (2016) 16:138 Page 10 of 10

27. Tasci-Duran E, Sevil U. A comparison of the prenatal health behaviors of

women from four cultural groups in Turkey: an ethnonursing study. Nurs Sci
Q. 2013;26(3):257–66.
28. de Vos AS, Strydom H, Fouché CB, Delport CSL. Research at grass roots: for
the social sciences and human service professions. 4th ed. Pretoria: Van
Schaik Publishers; 2011.
29. Miles MB, Huberman AM. Qualitative data analysis: an expanded
sourcebook. California: Sage Publications; 1994.
30. Kaphle S, Hancock H, Newman LA. Childbirth traditions and cultural
perceptions of safety in Nepal: critical spaces to ensure the survival of
mothers and newborns in remote mountain villages. Midwifery.
2013;29(10):1173–81.
31. Bianco PM. Prayers for healing and for deliverance, protection prayers. 2015.
Retrieved from: http://www.archangededieu.org/prieres-2/prieres-liberation-
guerison/prayers-healing-deliverance-exorcism/. Accessed Dec 2015.
32. Johnson MR. Faith, prayer, and religious observances. Clin Cornerstone.
2004;6(1):17–24.

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