NIÑA DULCE DY-LIM, RN MSNG 205

PROFESSOR RHEA FAYE D. FELICILDA, RN, MAN, LNC SAT 3-7PM

Cultural Perspectives in Childbearing

• Childbirth, a time of transition and celebration, is centrally important in
societies, as their cultural values, customs, and beliefs lend perspective to
the meaning of childbirth.
• A knowledge of cultures and the influence they have on women’s perception
of childbirth can help nurses in promoting positive outcomes for women and
their families

Key concepts of cultural sensitivity

• Culture is the way of life of a group if people, including the shared concepts
and patterns of learned behaviors that are handed down from one generation
to the next
• Cultural values refer to the powerful, persistent forces that give meaning and
direction to the actions, decisions, and lifestyle of a person, group, or family.
• Subculture is a group within a larger cultural system that retains its own
characteristics, such as complex traditions concerning health beliefs
• Nurses working in a multicultural society need to be sensitive to the cultural-
blurring effects of assimilation and acculturation
• Assimilation occurs when people take on the values, beliefs, and behaviors of
the major culture abandon their own ethnic traditions
• Acculturation happens when people accept their own culture and other
cultures, adapting elements of each
• Ethnocentrism refers to the view that a particular culture’s way of doing
things is the right and natural way
• Cultural relativism the opposite of ethnocentrism , refers to learning about
and applying the standard of another person culture to a situation
• This approach does not require nurses to keep the beliefs and values of
another culture but to recognize that other’s behavior may be based on a
system different from their own.
• Nurses caring for childbearing families should consider all aspects of culture,
including communication, space, time and family roles
• Communication encompasses an understating of not only a person’s
language, including dialect, style, style, and loudness of speech, but also the
meaning of touch and gestures
• Personal space and the dimension of comfort room, touching, placing
patients in close proximity to others, and taking away personal possessions
can reduce patients’ personal security and heighten their anxiety
• A cultural group maybe oriented to the past, present , or future
• People who focus on the past strive to maintain traditional and have little
motivation for formulating future goals
 • Cultural norms also have an impact on family roles, expectations, and
behaviors associated with a member’s position in the family

Childbearing Beliefs and Customs

• To provide culturally care for women during childbearing years, nurses

should become familiar with the practices and customs important to the
culturally diverse families in the area of the country where they practice

Asian-Americans

• From China, Japan, Korea, the Philippines, and Southeast Asian countries
• View pregnancy as a natural process when the mother “has happiness in her
body”
• Common beliefs include omitting milk from the diet because it will cause
stomach distress and avoiding inactivity and sleeping late because they could
result in a difficult birth
• “humeral theory”
• These humors are referred to as yin (hot) and yang (cold)
• Those who adhere to it believe it is necessary to maintain a balance “hot”
and “cold” elements in nature, the body, and the environment
• They consider pregnancy to be a “hot” condition
• Blood is considered “hot”
• New mothers need to restore balance by increasing the return of hot forces
believed to be present in hot food, hot water, and warm air
• Nurses are therefore advised to encourage the new mother to drink rea or
hot water rather than cold fruit juice (which is considered a “cold” substance-
not because of temperature, but because of classifications of hot and cold) or
water
• Husbands do not actively participate in the birthing process
• The celebrations and gifts in our culture focus upon the newborn infant,
those in non-Western cultures tend to focus upon the new mother
• Asian-American culture encourages breastfeeding, but some subcultures may
delay breastfeeding until the milk comes in. based on the belief that
colostrums is harmful for the baby
• Chinese babies are given and called by ugly nicknames in addition to the
“real names” that appear on their birth certificates to ward off spirits who
might want to kidnap the child

Hispanic-Americans

• Encompass those origin is Mexico, Puerto Rico, or Central or South America,

• Children are highly valued and desired
• Pregnancy is viewed as a normal, healthy state, which may result in late
entry into prenatal care
• Prefer to use a “partera” or lay midwife
 • The expectant mother is strongly influenced by her mother-in-law and may
prefer the presence of her mother, rather than husband
• Crying out in pain, in response to labor pain is accepted during labor
• For the first two days, the mother is permitted to drink only boiled milk and
eat roasted tortillas because these foods are believed to restore warmth to
the body
• Bathing is delayed for 14 days
• Breastfeeding usually does not begin until after the third day because
colostrums is considered “filthy” or “spoiled”

Middle Eastern (Arab-Americans)

• People from Syria, Turkey, Saudi Arabia, Egypt, Iran, and Pakistan as well as
others of the Muslim religion
• Pregnant women usually turn to their mother-in-laws for advice and guidance
• It is an Iranian custom to award the women with a gift after childbirth; and
the greater the pain, the larger and more expensive the gift will be
• Require that a Muslim woman cover her hair, body, arms to the wrist, and
legs to the ankles at all times
• The woman is not to be alone in the presence of a man other than her
husband or a male relative
• Most Arab-American women will breastfeed, which the Quran encourages,
until the child is 2 years old
• Infant boys are usually circumcised
• The naming of Middle Eastern newborns is usually postponed until the child is
7 days old
• The advice of family members is highly valued and followed
• Seek medical assistance only when all resources available at home fail
• Indian women also fast during pregnancy to be blessed with a son
• A show of emotion and affection is not encouraged among East Indians, so a
husband may not even ask how his wife is doing
• During postpartum period, the woman is secluded, kept warm, and given
only high-protein “hot” foods
• She is considered to be in a state of purity

Black Americans

• Perceive pregnancy as a state of well-being, so they may delay seeking

prenatal care
• Cultural beliefs may include that having a photograph taken during
pregnancy will cause stillbirth or reaching up will cause the cord to strangle
the baby
• During the postpartum period, virginal bleeding may be seen as a sign of
sickness
• Breastfeeding is embarrassing
• Mothers tend to introduce solid food early on
Caring for American nontraditional childbearing families

• Involving single-parent, adolescent, homosexual, and/or biracial families

• New members acquire cultural backgrounds from their parents and family
caretakers
• Adolescent pregnancy increases the risk of negative consequences for the
mother and children, such as poor maternal-infant bonding and a higher
incidence of poor intellectual functioning in children
• Research has indicated that adolescent mothers with a positive self-concept
and strong support system are more apt to succeed in the transition to
parenthood
• That maternal-child nurses reinforce young mothers’ self concept and
strengthen their social support systems by involving infants’ father,
grandparents, and other family members
• Lesbian couples bearing children face psychosocial dilemmas related to their
lifestyle and social stigma
• Most fear is of unsafe and inadequate care from healthcare providers once
the mother’s sexual orientation is revealed
• Nurses must keep in mind that lesbian parents are dedicated to bringing new
lives safely into the world to love and care for
• Homosexual couples may have unique needs when it comes to social
discrimination, family and social support networks, and legal issues of
adoption by the partner
• Biracial family is another form increasing in incidence and social acceptability
• Childbearing couples of mixed ethnicity had to bear hostility, contempt, and
rejection from both cultural groups
• Dual identification and multicultural environments may be associated with a
positive sense of racial identity

Nursing Implications

• The development of cultural competence requires that nurses engage in

ongoing cultural self-assessment and overcome any ethnocentric tendencies
• They must struggle against stereotypes that perpetuate prejudice and
discrimination against members of certain groups
• Competence, holistic nursing results from incorporating this awareness into
the care we give to our patients