Perinatal Cultural Awareness

Culture is defined as the values, beliefs,

and practices of a particular group that
incorporates attitudes and customs
learned through socialization with others.
Culture includes language,
communication style, traditions,
religions, art, music, dress, health
beliefs, and health practices.
Ethnicity has an influence on culture and is
the bond or kinship a person feels with his/her
country of birth or place of ancestral origin.
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Perinatal Cultural Awareness

Cont.
The movement is toward eliminating
acultural nursing care, which is the
traditional tendency to treat all clients as
though no cultural differences exist.
Culturally-competent nursing is care
that respects each clients culture and
shows respect for the values and beliefs
of others.

Perinatal Cultural Awareness

Cont.

The United States predominant

culture is Anglicized or Englishbased, with a general culture tendency
to:

Freely express positive/negative feelings.

Prefer direct eye contact when
communicating.
Address people in a casual manner.
Prefer a strong handshake as a way of greeting.
Include fathers in childbirth classes, labor, and
birth.
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SUBCULTURES
There are four major subcultures in
the USA. An awareness of general
communication patterns among
these subcultures can assist a nurse
in providing quality nursing care.
These four subcultures are:
1. Native Americans.
2. African Americans.
3. Latinos/Hispanics.
4. Asian Americans.
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Native American Culture

Generally private, hesitate in
sharing personal information, and
consider impatience disrespectful.
Believe no person has the right to
speak for another and may refuse to
comment on a family members behalf.
Believe lingering eye contact is an
invasion of privacy and
disrespectful.
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Native American Culture,

continued

They consider strong handshake as

offensive and prefer a light passing of the
hands.
Stoicism (indifference to pleasure or pain) of a woman is
encouraged during labor and birth.
Fathers may be absent during the delivery
but present at other times, such as naming
the infant. (Dont assume there is no father figure if
the father is not present during L&D).

Female family and friends attend to the

client during L&D.
Some families may want the placenta
returned. Ask if they do and who should
receive it.

African American Culture

Generally hesitate to give more
information than what is asked for when
in a health care environment.
Communication style is frequently loud
and animated with lots of body
movement.
They are comfortable with close personal
space with friends and family.
Sustained eye contact varies dependent
upon generation. (Older adults should not be looked
directly in the eyes).

Expressions of pain are usually open and

public.
Fathers are frequently active
participants in L&D.
Traditionally, female attendants frequently
accompany the laboring client.

Latino/Hispanic Culture
They are comfortable sitting close to
interviewers.
Evil eye (placing a bad omen or curse) can be
given to a child if the child is admired and
the admirer does not touch the child.
They consider direct eye contact as
attentive and respectful.
Men are generally protective and
authoritarian regarding women and
children, and expect to be consulted in
decision making.
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Latino/Hispanic Culture
Cont.
Fathers, especially the older
generation, may prefer to not play
an active role in the labor and
birthing process. (They prefer to
observe or wait outside).

Women are generally vocal and

active during L&D and prefer to
keep their body covered.
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Asian American Culture

They generally respond with brief factual
answers and they dont openly disagree
with authority figures (PCP, nurses) so they
may conceal their noncompliance.
They believe prolonged lingering eye
contact is an invasion of privacy and
disrespectful.
They feel more comfortable with the nurse
at more than an arms length away in
distance.
They consider the head to be sacred and it
can only be touched by close relatives.
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Asian American Culture Cont.

The area between a womans waist and
knees should not be touch by any male
other than the womans husband.
They tend to control their emotions and
expressions of physical discomfort.
Do not address them by the first name
initially unless told to do so.
Modesty is important.
Female family members are usually present
at the birth. The father and other male
family members usually do not
participate in birthing classes or the
L&D.
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Nursing Assessments
To provide culturally-competent care, a
perinatal nurse should attempt collect
data about the unique characteristics
of a clients culture. Data includes:
Language and communication style
(eye contact, body space and distance, touch and
emotional expression).

Hygiene practices.
Feelings about modesty
her caregiver is of concern).

(whether gender of

Special clothing or ornamentation

(certain Mexican women wear a cord beneath their breasts
and knotted over the umbilicus because they believe it
prevents morning sickness and ensures a safe birth).

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Nursing Assessments Cont.

Religion and religious practices . For
example, Muslim fathers whisper a prayer in the neonates
ear immediately after birth and shave the infants head.

Rituals surrounding birth . (Practices she

expects to follow while pregnant).

Family and gender roles

(who she
expects/wants to provide labor support during the birthing
process).

Proper forms of greeting and showing

respect.

Food habits and dietary restrictions .

For example Asian cultures permit pregnant women to eat
only warm foods. Muslims may eat only Halal meats, Jewish
heritage may eat only kosher foods. Many Muslim and Jewish
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people do not eat pork.

Nursing Assessment Cont.

Methods for making decisions.
Health beliefs and illness practices.

(Breastfeeding preferences, circumcision, use of belly bands on

umbilicus, use of herbs to increase milk flow, the use of olive or
castor oil to stimulate passage of meconium). Examples
include:

In some cultures, a PCP is not needed during

pregnancy because it is considered a healthy
state.
Some Mexicans may believe that a pregnant
woman should not witness an eclipse because it
may cause a cleft palate in the newborn.
Many Native Americans and Asians encourage
pregnant women to be active and walk.
Filipinos may commonly believe that any activity
is dangerous and others take over the work for the
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pregnant and postpartum woman.

Nursing Diagnoses
Acute discomfort r/t cultural
differences in the communication of
pain.
Coping: readiness for enhanced
family r/t anticipation of newborn.
Anxiety/fear r/t cultural differences of
caregivers and clients.
Communication: impaired r/t cultural
differences.
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Nursing Interventions
Work with a knowledgeable interpreter to
provide information and answer questions as
needed. Explain all procedures and ensure
understanding.

Addressing the client as she prefers.

Use of culturally sensitive communication
techniques such us sitting or standing in the
client's cultural comfort zone and making
appropriate eye contact.
Respect the clients food preferences and
help her plan an adequate prenatal diet.

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Nursing Interventions Cont.

Provide a female caregiver if that is
desired.
Respect the clients decision
regarding support person involvement
and avoid imposing personal values or
expectations.
Honor the clients health beliefs and
practices and provide for requested
preferences unless practices are
contraindicated because of safety. (Example:
Removing medals or clothing that hold religious or symbolic
meaning).

Apologize if cultural traditions or beliefs are

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violated.

Cultural Awareness .
It is essential to the nurse to
remember that diversity exists
within cultural groups and take
care not to stereotype.
It is important for the nurse to
examine his/her own cultural beliefs
and take care not to exhibit
behaviors of ethnocentrism (belief
that ones own ethnicity and culture are superior
to all others).
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References
Wissmann, J., & Stomboly, J. (2007). Perinatal Cultural Awareness.
Maternal Newborn Nursing (7.1 ed., pp. 55-64). Kansas City, MO:
Assessment Technologies Institute.

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