Group 6
*Pregnancy and culture
All cultures recognize pregnancyall cultures recognize
pregnancy as a special position. I may have practice tonight.
They activity and behavior during pregnancy.
 Biologic Variation
Knowledge of certain Biologic variation resulting from genetic
and environmental backgrounds is important for nurses who
care for childbearing families. For example, pregnant women
who have the sickle cell trait and are heterozygous for the sickle
cell gene are at increased risk for asymptomatic bacteriuria and
urinary tract infection such as pyelonephritis.
 Cultural Variation
Several cultural variation might influence pregnancy. Those
highlighted in this chapter include alternative lifestyle choices
nontraditional system culture believes related to parental
activity during pregnancy and food Taboos and cravings .
 Alternative lifestyle choices
-Despite recent cultural changes that have made it more
acceptable for a woman to have careers and pursue alternative
lifestyle, the dominant cultural expectation for North American
women remains motherhood within the context of the nuclear
family.
 Infant relinquishment
-is In direct conflict with western idea cultural values, which
suggests that all parents Want a child.
 Lesbian couple childbearing
- occurs in another subculture of pregnant women with special
needs. This group of women faces psychosocial dilemmas
related to their lifestyle and social stigma.
 Nontraditional support systems
Culture of variation that Has important implication is a woman’s
perception of the need for formalized assistant from healthcare
providers during the other antepartum period. Western medicine is
generally perceived as having a curative rather than a preventive
focus. Indeed, may healthcare providers view pregnancy as a
disaster waiting to happen, a psychologic state that at any moment
will become pathologic.
 Cultural Beliefs Related to Parental Activity During
Pregnancy
Cultural variation also involve beliefs activities during
pregnancy . A belief is something held to be actual or true on
the basis of a specific rationale or explanatory model.
Prescriptive beliefs, which are phrased positively, describe
expectancies of behavior,the more common restrictive beliefs
which are phrased negatively, limit choices and behavior.
 Food taboos and cravings
Among many subcultures , women perceive little personal
control over the outcomes of pregnancy except through the
avoidance of foods that are considered taboo.
 Cultural Prenatal Care
Morgan’s (1996) study of African- American women explored
beliefs,practices, values related to prenatal care. The findings
indicated that many of the women in urban areas lacked trust
and were apprehensive about their current life circumstances.
Urban African- American women indicated that they had less
support than their contemporaries in the rural South.
 Cultural Interpretation of Obstetrics Testing
Many women do not understand the emphasis that western
prenatal care places or urinalysis, blood pressure readings, and
abdominal measurements.For traditional women,the vaginal
examination might be so intrusive and embarrassing that they
might avoid prenatal visit or request a female physician or
midwife.
 Cultural Preparation for Childbirth
Preparation for childbirth can be developed through programs
that allow for cultural variation, including classes during and
after the usual clinic hours in busy urban settings,teen - only
classes, single mother classes, group classes combined with
prenatal checkup at home, classes on rural reservation, and
presentation that incorporate the other “wise women” of the
community. In addition, nurses can organize classes in language
other than English.
*Birth and culture
Beliefs and Customs surrounding the experience of labor and
delivery are influenced by the fact that the physiologic
processes are basically the same in all culture. Factors such as
cultural attitudes towards the achievement of birth, methods of
dealing with the pain of labor, recommended position during
delivery, the preferred location for the birth, the role of the
father and the family, and expectations of the health care
practitioners might vary according to the degree of
acculturation to Western childbirth customs, geographic
location,religious beliefs , and individual preferences.
 Traditional Home Birth
All cultures have an approach to birth rooted in a tradition in
which childbirth occurs at home, within the province of
women.For generations, traditions among the poor included
the use of “ granny” midwives by ruralAppalachian whites and
southern African American and parteras by Mexican Americans.
 Support During Childbirth
Despite the traditional emphasis on female support and
guidance during labor, the inclusion of spouses and male
partners in North American labor and birth rooms has been
seen as positive by women of many cultures. Fortunately,this
situation has changed a great deal in the past few years, so that
husbands or partners now make important contributions
supporting and helping pregnant women during labor.
Some women and families, particularly those from Orthodox,
Jewish, Islamic , Chinese, and Asian Indian backgrounds, might
follow strict religious and cultural prohibition against viewing
the woman’s body by either the husbands or any other man, or
they might practice separation of the husband and wife once
the “ bloody show” or cervical dilation has occurred.
 Cultural Expression of Labor Pain
Although the pain threshold is remarkably similar in all persons
regardless of gender, social,ethnic,or cultural differences, these
differences play a definite role in a woman’s perception of labor
pain.
 Birth Position
Numerous anecdotal reports in the literature describes “ 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.
Economically disadvantaged women from culturally diverse
backgrounds have few birth options; most labor and given birth
in large public hospitals.
 Cultural Meaning Attached to Infant Gender or
Multiple Births
The meaning that parents attach to having a son, daughter, or
multiple births varies from culture to culture. Traditionally, the
male gender is highly regarded, which places female infants in a
position of “ less than favorable”. In certain Asian and Islamic
cultures, it is felt that a male child is preferable to a female
child .
*The Postpartum Period
Western medicine considers pregnancy and birth the most
dangerous and vulnerable time for the childbearing woman.
However other cultures places much more emphasis on the
postpartum period.
Routine postpartum nursing care usually includes encouraging
a healthy diet, adequate fluid intake , and self -care practices
such as good hygiene practices ,site baths , showering ,
bathing , ambulating, and exercise . However, these practices,
common in North American obstetrics care ,might seems
strange and even dangerous to women of other cultural groups.
Imbalance is perceived to be the result of disharmony caused
by the processes of pregnancy and birth, and pollution is seen
to be caused by the “ unclean” bleeding associated with birth
and the postpartum period.Restitution of physical balance and
purification might occur through many mechanism, including
dietary restrictions, rituals baths,seclusion,restrictions of
activity, and other ceremonial events.
 Hot/Cold Theory
Central to the belief of perceived imbalance in the mother’s
physical state is adherence to the hot/coldtheories 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/cold beliefs , Yin and Yang .
Postpartum Dietary Prescriptions and Activity Levels
Dietary prescription are also common in this period. The nurse
might note that woman eats little “hospital” food and relies on
family and friends to bring food to her while she is in the
hospital. If there are no diet restrictions for health reasons this
practice should be respected indeed the nurse should assess
what types of food are being eaten by the woman and
documenting them as appropriate.
*Culturally Competent Nursing Care for Vulnerable Clients
During Pregnancy
In this section culture not only will be viewed from an ethnic or
culturally diverse point of view but additionally will examine
“cultures within a culture “or subcultures. Some of the shared
characteristics include stress (physical and emotional) poor
lifestyle health practice, delayed prenatal care, lack of support ,
and exposure to violence. This section will examine the
ideologist of each group and offer recommendations about
how nurses can offer support to vulnerable pregnant women in
these unique circumstances.
 Physically Abuse Pregnant Women
Main forms of abuse in the pregnant population warrant
attention and discussion . In This section however the focus will
be on the physical abuse of pregnant women. Information
regarding women in abusive situation is scarce, partly because
of under reporting.Important information we do know is that
abuser women are less likely to seek healthcare because their
abuser limits access to resources and battering occurs more
frequently during pregnancy.
 Hispanic Pregnant Women
Although there are many different Hispanic groups they do
share some important commonalities example
religion,customs, and language as with any cultural group
differences exist among the members. Incidence of wife abuse
among pregnant Hispanic women is not clear in the literature.
Access to healthcare for pregnant and Hispanic women is
problematic barrier to prenatal healthcare include lack of
healthcare insurance; low levels of education ,which
encourages the use of traditional healers and remedies and my
foster mistrust of physicians and nurses and lead to non
compliance when pregnant women do use modern medicine;
lenghtly travel time to clinic it followed by long waits and the
lack of Spanish speaking healthcare professionals. Hispanic
women tend to be in low-paying jobs whose annually earnings
are considerably less than those non-Hispanic women.
honor.
Since the 1970s , Native North American tribes have
made an effort to develop programs to meet the
needs of their communities. However , abuse among
women has not been addressed adequately because
of the male – dominated leadership , other needs of
tribes , and the shame associated with abuse [ Bohn ,
1993].
 HOMELESS PREGNANT WOMEN
Issues related to homelessness are multiple and
complex , but for a pregnant homeless woman , this
time of physiologic and psychologic change without
proper medical management is particularly
problematic. Evidence – Based practice 5-7 summarize
a study by killion (1995) and includes interventions for
criminal appilication.

 Black Pregnant Women

Cultural Beliefs of blacks emphasize the larger black
society rather than focusing on individuals, making
‘’all’’ collectively responsible for one another
[McNair,1992]. Therefore, black women exists in a
social context supported by social connectedness
versus that of autonomy. One of the most difficult
barriers confronting black abused women attempting
to get help from police or from the legal system is the
stereotypical view suggest that violence among Black
is normal [Hawkins,1987].
 NATIVE NORTH AMERICAN PREGNANT WOMEN
Violence with families has not always been part of
Native North American society. Albers and medicine
[1983] noted that before contact with Europeans ,
Native North American society was based on harmony
and respect for nature and all living things , sharing ,
and cooperation. Traditionally , cruelly to women and
children resulted in public humiliation and loss of