Explore beliefs and practices of a client regarding their activities of daily living in
different cultures
cultural perspectives in childbearing women and children
Culture Health & Society
Ramesh kumar
pg. 1
Objectives
At the end of presentation leaner will be able to,




Define the cultural perspectives in childbearing women and children
Discuss the Childbearing Beliefs and Customs
Describe fertility control and culture
Briefly explain nursing Implications

Enlist Factors influence child rearing (education)

Join up Culture specific childrearing practice

Enroll South Asian folk healing practice in children
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Sign on Protected the children from various illness in culture
pg. 2
Cultural Perspectives in Childbearing women


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 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
pg. 3

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 goal
 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”

Some pregnant women experience pica : the craving for and ingestion nonfood substance , such a
clay or laundry starch

Some Hispanic women prefer the solid milk of magnesia that can be purchased in mexico

Other women eat the ice or frost that forms inside refrigerator units
pg. 4

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 read 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 “parterre” 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”
pg. 5
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 is7 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 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
pg. 6
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 ( uneasy)

Mothers tend to introduce solid food early on
Caring for American nontraditional childbearing families

Involving single-parent, adolescent, homosexual, and/or biracial families
(consisting of, representing, or combining members of two separate
races: a biracial committee on neighborhood problems.)

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

(Lesbian couple) A same-sex relationship is a relationship between two persons of the same sex
and can take many forms, from romantic and sexual, to non-romantic homosocialy-close
relationships. The term is mainly associated with homosexual people

Most fear is of unsafe and inadequate care from healthcare providers once the mother’s sexual
orientation is revealed
pg. 7

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 appositive sense of
racial identity
Fertility control and culture

A women fertility varies method , intrauterine device (IUDs) , permanent sterilization and to less
degree, barrier and “natural method

The religious beliefs of some culture group might affect their use of fertility controls such as
abortion or artificial regulation of conception for example Roman Catholics might follow church
edict(law) against artificial control of conception

Mormon families might follow their church’s teaching regarding the spiritual responsibility to
have large families and promote church growth.

(Christian Churches, other) a prophet whose supposed revelations were recorded by Joseph Smith
in the Book of Mormon

The ability to control fertility successfully also required an understanding of the menstrual cycle
and the time and condition and understanding bodily functions.

Use of artificial method of fertility control might alter the body’s usual cycles; women who use
them might become anxious, consider them ill and discontinue the method.

Religious belief can also influence birth control choices for example the Hindu religious teaches
that right hand is clean and the left is dirty. The right hand is for holding religious books and
eating utensils and the left hand is used for dirty things such as genitals.
pg. 8

The belief complicates the use of contraceptives requiring the use of both hands such as a
diaphragm.

Buddhism value a celibate life and natural things. Modern contraceptives are nor considered
natural by this group and are therefore unacceptable.

In general Islamic Ruling, most forms of contraception and birth control are forbidden.

Guatemala believes strongly in privacy, therefore skirts are kept on during intercourse and child
birth.

Hinduism encourages reproduction within marriage, yet there is no opposition against
contraception

Guatemala City The capital and largest city of Guatemala, in the south-central part of the country.

Some women also believe it is improper to touch or exposé their genitals making traditional birth
control method such as abstinence(self denial) or the rhythm method much more acceptable.
Nursing Implications
 The development of cultural competence requires that nurses engage in ongoing cultural selfassessment 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
pg. 9
Cultural Perspectives in nursing care of children
Culture survival depends on the transmission of values and customs from one generation to the
next a process that relies on children for its successes.
Factors influence child rearing (education)
factor
childreaing
poverty
height &
wegiht
infant
attachemnt
cry
1. Poverty

Impact of poverty on children health is cumulative throughout the life cycle. Example
when poverty leads to malnutrition during so called critical period or the first 2 year
of life
2. Height and weight

Why prematurity defined as birth weight less than 2.5 g (5 Ib , 8 oz)
3. Infant attachment

German mothers expect very early autonomy in the child in the child and had few
physical interventions as the child plays along

Japanese there are infrequent mother child separation and the mother has close
physical interactions with the child during play. stay near their infant a great deal to
do may thing for them
pg. 10

Anglo American mother tend to have few physical intervention when the child to
playing an they encourage exploration and independence
4.
Crying
1. Culture difference exist in mothers developmental goal for their infants and in the
way they perceive, react, and behave in response to their infant , cues, behaviors and
demands knowledge of cultural difference in parental l response to crying .
Culture specific childrearing practice
culture speciifc child
rearing practice
nutrition
sleep
elimaintion
parent child
reationship
and discipline
children
abause
1. Nutrition : feeding and eating behavior

Many cultures breastfeeding is traditionally practiced for varying lengths of
time after the birth of an infant 1 year to 2 year until birth of the next child

Navajo, black, Mexican North American and other group demonstrate that
caregivers frequently prop a bottle filled with milk, juice, or soda pop with the
pg. 11
infant when he or she goes to sleep this practice known as to cause dental
caries.

Some culture mothers might permasticate or chew the food for infant and
young children in the belief that this will facilities digestion. This practice
most reported among black and Hispanic mother with low socioeconomic
status.
2. Sleep

Common cultural practice cosleeping the practice of parents and children
sleeping together for all or part of the night is common in families with young
children

Traditional American infant sleep on a pandauns mat covered with a blanker
ad sometimes a pillow is used.

A cradleboard is used by several is made of cedar pine or pifion wood and
might be decorate in various ways , depending on the affluence of the family
and on tribal customs

Cradleboard helps the infant feel secure and can be moved around with ease.
3. Elimination

Primary concern to parents is bowel and bladder control which is the concern
of considerable attention by parents of toddlers and preschoolers.

Most children achieve dryness 2 ½ to 3 year age bowel training is more easily
accomplished than bladder training,

Day time or diurnal wetting is less frequent than nighttime or nocturnal
wetting

Boys have a more difficult time achieving bladder control than girls

Constipation in child a persistent concern among parent who expect a
ritualistic daily pattern. Some culture infant is given herbs.
4. Parent –child relationship and discipline

The relationship with mother is primary and father remains somewhat distant

Some culture encourage children to participate in family decision making and
to discuss or even argue point with there parent example encourage age
pg. 12
children to express opinions verbally and to take an active role in all family
activity

Many Asian parents value respectful deferential behavior towards adults who
considered experience and wise

Many Asian children are discourage for making decision independently

Physical punishment of native north American can children is rare but Asian
is more common
5. Child abuse

Child abuse and neglect have been documented thought hum history and as
known across culture

To explore physical abuse and neglect , sexual molestation, child prostitution ,
nutritional deprivation emotional maltreatment and institution abuse from a
cross national perspective
South Asian folk healing practice
southasian
folk healing
practice
coining
burning
cupping
pinching
pg. 13
1. Coining ( cao gio)

Coining: is exudes the “bad wind” appearance of a deep radish purple skin color
is confirmation that the person indeed had “ bad wind” in the body than coining
was appropriate treatment

Age : infant a few months old through seniors

Appearance : superficial ecchymotic no painful area with patchier usually
appearing between the rib bones on the from and back of the body resembling
straw marks.

Procedure : special menthol oil or ointment is applied to the painful or
symptomatic area

China,Cambodian is common
2. Burning (poua)

Burning : is exudes the noxious element causing the pain or illness

Age: : infant a few months old through seniors

Appearance : asymmetric , superficial, painful burns ¼ inch in diameter
appearing ether as single burn in the center of the forehead

Procedure : a tall weed like grass is applied and allowed to dry. The end is dipped
in heated melted pork lard, and the tip is then ignited and applied to he skin in the
area requiring treatment

The treatment is painful
3. Cupping ( ventouse)

Cupping : suction show the noxious element. The greater the “bruise” the greater
the serious of the illness

Age : adults , occasionally teens

Appearance :circular , no raised ecchymotic ,painful burn marks 2 inches in
diameter usually appearance in systemic .

Procedure : the principle is to create a vacuum inside a special cup by igniting
alcohol soaked cotton inside the cup. When the flame extinguishes, the cup is
immediate applied to the skin of the painful site. Suction is created and the skin is
pg. 14
pulled up inside the mouth of the cup. The cup remains in place 15 to 20 minutes
or until the suction can be easily released

T he procedure is painful.
4. Pinching ( bat gio)

Pinching: show the bad wind or noxious element

Age: children over 10 years old are most cultures adult only H’mong culture.

Appearance: intensely ecchymotic, isolated non symmetric area. May be present
anywhere on the body including on the forehead, between the eyes.

Procedure : index and middle finger of one hand are flexed and firmly applied to
the skin in a quick, pinching motion. Ginger balm a penetrating mentholated
ointment
may be massaged into the area before pinching.
Protected the children from various illness in culture
protected
children
various illnes
punoj(
grunting)
mal ojo( eye
evil)
caida de la
mollera or
fallen fontanel
ghost illness
ghost
possession
pg. 15
1. punoj( grunting)

an illness manifested by grunting sounds and protrusion of the umbilicus .

it is believed to be caused by contact with a women who is menstruating or by the
infants own mother if she menstruated sooner than 60 day after delivery.
2. Mal Ojo( Eye Evil)

an affliction feared throughout much of the world

the condition is said to be caused by an individual who voluntarily or involuntarily
injury a child by looking at or admiring him or her

the individual has desire to hold the child but there wish is frustrated by the parent
of the infant or by the reserve of the individual

several hours later, the child might cry and experience, ,fever vomiting diarrhea,
and loss of appetite .

the child’s eyes might rollback in the head her she will become listless

parents or grandparents might wish to place an amulet, talisman, or religious object
such as a crucifix or rosary on the child or near to the head
3. caida de la mollera or fallen fontanel

has variety of cause for the Mexican America such as failure of the midwife ot
press preventively on the palate after delivery

falling on the head abruptly removing to nipple for the infant mouth, and failing to
place a cap on the infants head have also been identifies as causes of caida de la
mollera.

The sign of this condition include crying fever, vomiting and diarrhea.

Given that care providers frequently note the correspondence of these symptom.
4. ghost illness ghost possession

Some Hindu from northern India, there is strong belief bound syndrome or folk
illness bases on the belief that ghost enter its it victim and tries to seize his or her
soul.

If the ghost is successful it caused of death.
pg. 16

Illness and the supernatural world are linked by the concept of ever and the ghost a
supernatural being discuss in the Mahabharata and the puranas the Hindus scared
scriptures

One sign of ghost illness is voice speaking through delirious victim this may occur
in child and adult.

When an infant or small child become ill and dies a mother or father might be
relieved of psychic tension form feeling of personal guilt by transferring the blame
for the death to a ghost
pg. 17
Reference

Margaret M. Andrews, PhD, RN, CTN (2012). Transcultural Concepts in Nursing Care
6th edition McGraw-Hill Education, London
pg. 18