Transcultural Perspective in Childbearing

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CHAPTER 5

TRANSCULTURAL
PERSPECTIVE IN
CHILDBEARING
GROUP 3 PRESENTERS:
JANELLA VIDAL MA. ALMIRA DOMINGO
IRISH ANN REPOLLO CHARLS BENZER RAYOS DARLENE DANA MANAOIS
TOPIC1:
FERTILITY CONTROL
AND CULTURE

These variables are further modified by cultural and


social variables, including marriage and residence patterns,
diet, religion, the availability of abortion, the incidence of
venereal disease, and the regulation of birth intervals by
cultural or artificial means, all of which are influenced
by cultural norms, values, and traditions.
Unintended Pregnancy

Unintended pregnancy can have numerous negative effects on the mother and the
fetus, including a delay in prenatal care, continued or increased tobacco and other
drug use, as well as increased physical abuse during pregnancy; any of these factors
can lead to preterm labor or lowbirth-weight (LBW) infants.
Contraceptive
Methods
The religious beliefs of some cultural groups
might affect their fertility controls such as abortion
or artificial regulation of conception.
Religion and
Fertility Control
The influence of religious beliefs on birth
control choices varies within and between
groups, and adherence to these beliefs may
change over time. Cultural practices tend to
arise from religious beliefs, which can influence
birth control choices.
Cultural
Influences on
Fertility Control
It is common for health professionals to
have misconceptions about contraception
and the prevention of pregnancy in
cultures different from their own.
TOPIC 2: PREGNANCY
AND CULTURE
All cultures recognize pregnancy as a special transition period,
and many have particular customs and beliefs that dictate activity
and behavior during pregnancy.
A. Cultural Variations
Influencing Pregnancy
Nurses must be able to differentiate among
beliefs and practices that are harmful and those that
are benign. Few cultural customs related to
pregnancy are dangerous and many are health
promoting.
1. Alternative McManus, Hunter, and Rennus (2006) found
four areas that are significant in regard to
lesbians considering parenting:
Lifestyle Choices
Many of today’s women (1) sexual orientation disclosure to providers
are career oriented, and they may and finding sensitive caregivers,
delay childbirth until after they
have finished college and (2) conception options,
established their career. Some (3) assurance of partner involvement, and
women are making choices
regarding childbearing that might (4) how to legally protect both the parents
not involve the conventional and the child. Lesbian and heterosexual
method of conception and pregnancies have many similarities.
childrearing.
2. Maternal Role
Attainment
If you give birth and become a mother,
the assumption is that you automatically become
“maternal” and successfully care for and nurture
your infant. However, many factors can affect
maternal role attainment, including separation of
mother and infant in cases such as illness,
incarceration, or adoption, to name only a few.
EXAMPLE:
The results indicated six internal and external
factors used to assist in attainment:
HIV-positive Thai mothers
selected for their successful (1) setting a purpose of raising their babies;
adaptation to the maternal (2) keeping their HIV status secret;
role. (3) maintaining feelings of autonomy and optimism
by living as if nothing were wrong, that is,
normalization;
(4) belief of quality versus quantity of support from
husbands, mothers, or sisters;
(5) hope for a cure; and
(6) belief that their secret is safe with their health
care providers.
3. Nontraditional
Support Systems
Because many cultural groups perceive pregnancy as a normal physiologic process, not
seeing pregnant women as ill or in need of the curative services of a doctor, women in these
diverse groups often delay seeking, or even choose not to seek, prenatal care.
Cultural variations also involve beliefs about
4. Cultural Beliefs activities during pregnancy. A belief is something
Related to Activity held to be actual or true on the basis of a specific
rationale or explanatory model. Prescriptive beliefs,
During Pregnancy which are phrased positively, describe what should
be done to have a healthy baby; the more common
restrictive beliefs, which are phrased negatively,
limit choices and behaviors and are
practices/behaviors that the mother should not do
in order to have a healthy baby. Taboos, or
restrictions with serious supernatural consequences,
are practices believed to harm the baby or the
mother.
● Remain active during pregnancy to aid the baby’s
Prescriptive circulation (Crow Indian)
● Keep active during pregnancy to ensure a small
Beliefs baby and an easy delivery (Mexican and
Cambodian)
● Remain happy to bring the baby joy and good
fortune (Pueblo and Navajo Indian, Mexican,
Japanese)
● Sleep flat on your back to protect the baby
(Mexican)
● Continue sexual intercourse to lubricate the birth
canal and prevent a dry labor (Haitian, Mexican)
● Continue daily baths and frequent shampoos
during pregnancy to produce a clean baby
(Filipino)
Restrictive
● Avoid cold air during pregnancy to prevent
physical harm to the fetus
(Mexican, Haitian, Asian)
Belief
● Do not reach over your head or the cord will
wrap around the baby’s neck
(African American, Hispanic, White, Asian)
● Avoid weddings and funerals or you will bring
bad fortune to the baby (Vietnamese)
● Do not continue sexual intercourse or harm will
come to you and baby (Vietnamese, Filipino,
Samoan)
● Do not tie knots or braid or allow the baby’s
father to do so because it will cause difficult labor
(Navajo Indian)
● Do not sew (Pueblo Indian, Asian)
Taboos
● Avoid lunar eclipses and moonlight or the baby might be born with a deformity
(Mexican)
● Do not walk on the streets at noon or 5 o’clock because this might make the spirits
angry (Vietnamese)
● Do not join in traditional ceremonies like Yei or Squaw dances or spirits will harm the
baby (Navajo Indian)
● Do not get involved with persons who cast spells or the baby will be eaten in the
womb (Haitian)
● Do not say the baby’s name before the naming ceremony or harm might come to
the baby (Orthodox Jewish)
● Do not have your picture taken because it might cause stillbirth (African American)
● During the postpartum period, avoid visits from widows, women who have lost
children, and people in mourning because they will bring bad fortune to the baby
(South Asian Canadian)
TOPIC 3:
BIRTH AND CULTURE
Traditionally, cultures have viewed the birth of a child in
one of two very different ways.
A.
Traditional
Home Birth
All cultures have an approach to
birth rooted in a tradition of home
birth, being within the province of
women.
B. Support
During Childbirth
Despite the traditional emphasis on female support
and guidance during labor, women from diverse
cultures report a desire to have husbands or partners
present for the birth.

Many women also wish to have their mother or


some other female relative or friend present during
labor and birth. Because many hospitals have rules
limiting the number of persons present, the mother-to-
be might be forced to make a difficult choice among the
persons close to her.
C. Cultural Expression
of Labor Pain
Although the pain threshold is
remarkably similar in all persons, regardless
of gender or social, ethnic, or cultural
differences, these differences play a
definite role in a person’s perception and
expression of pain.
D. Birth
Positions
Numerous anecdotal reports in the
literature describe “typical” birth positions for
women of diverse cultures, from the seated
position in a birth chair favored by Mexican
American women to the squatting position
chosen by Laotian Hmong women.
E. Cultural
Meaning Attached The meaning that parents attach
to having a son or daughter varies
from culture to culture. Historically
to Infant Gender in the United States, families saw
males as being the preferred
gender of the firstborn child for
reasons including male dominated
inheritance patterns, carrying on the
family name, and becoming the
“man” of the family should the need
arise.
TOPIC 4:
CULTURE AND THE POST
PARTUM PERIOD
Western medicine considers pregnancy and birth the
most dangerous and vulnerable time for the childbearing
woman. However, other cultures place much more
emphasis on the postpartum period.
A.
Postpartum
Depression Insights provided by the literature suggest
nurses should assess new mothers for
culturespecific signs of PPD with the understanding
that not all cultures recognize PPD as a medical
disorder. Symptoms we associate with PPD are
viewed differently in other cultures, for example, as a
sign of “spirit possession,” as in some traditional
Muslim cultures.
B. Hot/Cold
Theory Central to the belief of perceived
imbalance in the mother’s physical state is
adherence to the hot/ cold theories of
disease causation. Pregnancy is considered a
“hot” state. Because a great deal of the heat
of pregnancy is thought to be lost during the
birth process, postpartum practices focus on
restoring the balance between the hot and
cold, or yin and yang.
C. Postpartum
The nurse might note that a
Dietary woman eats little “hospital” food and
relies on family and friends to bring
Prescriptions and food to her while she is in the
hospital. If there are no dietary

Activity Levels restrictions for health reasons, this


practice should be respected. Fruits
and vegetables and certainly cold
drinks might be avoided because
they are considered “cold” foods.
D. Cultural Influences on
Breast-Feeding and Weaning
Practices
Cultural Influences on Breast-Feeding and
Weaning Practices The World Health
Organization and UNICEF (2010) recommend
children worldwide be breast-fed exclusively for
the first 6 months of life followed by the
addition of nutritional foods, as they continue to
breast-feed for up to 2 years, with no defined
upper limit on the duration.
E. Cultural Issues Related to Intimate
Partner Violence During Pregnancy
Domestic violence has emerged as one of the most
significant health care threats for women and their unborn
children. Numerous transcultural factors influence the prevalence
of and response to domestic violence, including a history of
family violence, sexual abuse experienced as a child, alcohol and
drug abuse by the mother or significant other, shame associated
with abuse, fear of retaliation by the abuser, or fear of financial
implications if the mother leaves the abuser, to cite a few.
EXAMPLE:
1. Hispanic Pregnant
Women Many Hispanic women tend to be in low-
paying jobs whose annual earnings are considerably
less than those of non-Hispanic women. They may
also have less education than White women and live
in large, extended households, often made up of
several children and extended family members.
2. African American
Pregnant Women
One of the most difficult barriers confronting African American
abused women who attempt to get help from police or from the
legal system is the stereotypical view that violence among African
Americans is normal. This view could cause African American
victims’ claims of abuse to be dismissed or ignored.
3. American Indian
Pregnant Women
Historically, cruelty to women and children resulted in public
humiliation and loss of honor. Cultural disintegration, poverty, isolation,
racism, and alcoholism are just a few of the problems that have fostered
violence in American Indian cultures. Nevertheless, cruelty to women
and children continues to be viewed by American Indians as a social
disgrace.

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