Giving birth: the voices of Ecuadorian women

Repairing the breach: identity narratives of a Latin American woman in Andalusia

Migration can be understood as a breach in life experience, creating a transition, and identity narratives as a strategy to repair this breach. Our study focuses on how two classical dilemmas that characterize this process are navigated in the narrative of migration of the participant (An Ecuadorian migrant woman in Andalusia): self versus others, and continuity of the self over time, despite changes. A semi-structured interview was conducted to achieve the objectives of the study. The interview was transcribed and analyzed on three axes: 1) Migration settings, identifying the dominant spaces of interaction where the migration narrative takes place; 2) Migration I-positions and voices, identifying the I-positions and voices involved in the narrative; and 3) Continuities and discontinuities in the identity narrative. The results demonstrated that the main settings and positions in the narrative were related to nationality, gender, and religion in relation to the dilemmas of self versus others and continuity versus change. These positions help the participant negotiate self-continuity in front of the changes associated with migration and the resistance against xenophobic discourses and positions in the host country. Results support the analysis of the transition processes associated to migration based on the concept of proculturation.

What matters to women during childbirth: A systematic qualitative review

INTRODUCTION

Design and provision of good quality maternity care should incorporate what matters to childbearing women. This qualitative systematic review was undertaken to inform WHO intrapartum guidelines.

METHODS

Using a pre-determined search strategy, we searched Medline, CINAHL, PsycINFO, AMED, EMBASE, LILACS, AJOL, and reference lists of eligible studies published 1996-August 2016 (updated to January 2018), reporting qualitative data on womens' childbirth beliefs, expectations, and values. Studies including specific interventions or health conditions were excluded. PRISMA guidelines were followed.

DATA COLLECTION AND ANALYSIS

Authors' findings were extracted, logged on a study-specific data form, and synthesised using meta-ethnographic techniques. Confidence in the quality, coherence, relevance and adequacy of data underpinning the resulting themes was assessed using GRADE-CERQual. A line of argument synthesis was developed.

RESULTS

35 studies (19 countries) were included in the primary search, and 2 in the update. Confidence in most results was moderate to high. What mattered to most women was a positive experience that fulfilled or exceeded their prior personal and socio-cultural beliefs and expectations. This included giving birth to a healthy baby in a clinically and psychologically safe environment with practical and emotional support from birth companions, and competent, reassuring, kind clinical staff. Most wanted a physiological labour and birth, while acknowledging that birth can be unpredictable and frightening, and that they may need to 'go with the flow'. If intervention was needed or wanted, women wanted to retain a sense of personal achievement and control through active decision-making. These values and expectations were mediated through womens' embodied (physical and psychosocial) experience of pregnancy and birth; local familial and sociocultural norms; and encounters with local maternity services and staff.

CONCLUSIONS

Most healthy childbearing women want a positive birth experience. Safety and psychosocial wellbeing are equally valued. Maternity care should be designed to fulfil or exceed womens' personal and socio-cultural beliefs and expectations.

Traditional practices for maternal and newborn care among Turkish postpartum women

AIM

Researchers used descriptive study design to examine the traditional practices of women in relation to maternal and newborn care in the postpartum period.

METHODS

523 postpartum women included who were between 15 and 49years of age, had at least one child, and had no medical complications that affect the mother-infant health. A questionnaire was used to collect data. Comparisons were made between the responses about the women's knowledge of traditional practices and other variables.

RESULTS

We found that women widely used traditional practices such as putting Koran (Holy book for Muslims) and packing needle under the mother's pillow to prevent mother from "al basması", pouring lead in a cup over the head of the newborn to repel evil spirits, and covering the baby's face with a piece of yellow cloth to prevent neonatal jaundice. The rate of using postpartum traditional practices increased with age and number of pregnancies and decreased with education (p<0.05).

CONCLUSION

Educational activities are recommended to increase awareness of harmful traditional practices in the field of reproductive health for nurses and midwives. Health professionals should pay special attention to less educated, older and primiparous women from rural areas enable them to reinforce positive cultural practices, and discourage them from using harmful ones by providing non-critical scientific explanations.

Escolha do tipo de parto: fatores relatados por puérperas

RESUMO Objetivo Conhecer os fatores relatados por puérperas que concorreram na escolha do tipo de parto. Métodos Pesquisa qualitativa, desenvolvida com 25 puérperas em um Hospital Universitário de Mato Grosso do Sul, entre setembro e novembro de 2014. Utilizou-se a entrevista semiestruturada para a coleta de dados e o Discurso do Sujeito Coletivo para organizar e tabular os depoimentos. Resultados Os Discursos dos Sujeitos Coletivos resultaram nas categorias: Desejo pelo tipo de parto realizado; Respeito pelo tipo de parto escolhido e Fatores que influenciaram a escolha. A maioria das mulheres entrevistadas (76%) manifestou preferência pelo parto normal devido à recuperação rápida, menor dor e sofrimento. Conclusões Concorreram na escolha do tipo de parto: influência da família, experiências prévias com parto, interação profissional – cliente e informações via internet, o que reforça a importância da educação em saúde desde o pré-natal, destacando a necessidade de instrumentalizar a mulher para realizar uma escolha consciente.

Maternal Experiences of Their Unborn Child's Spiritual Care: Patterns of Abstinence in Iran

Preparing for pregnancy and childbirth has significant association with spirituality. Review of the literature shows that the spirituality of the "unborn child" has not yet attracted much critical attention. This study was conducted with the aim of exploration of maternal behaviors associated with the spiritual health of the unborn child. A qualitative approach was used to investigate the research question. Twenty-seven in-depth unstructured interviews were conducted with 22 Iranian mothers in Tehran city (Iran) who were pregnant or had experienced pregnancy in 2012-2013. Data analysis was carried out using a conventional content analysis approach. "Refusing to eat forbidden food," "Overcoming mental adversity," "Regulating one's social interactions," "Preventing the effects of harmful environments on the senses," "Avoidance of using insulting and abusive language," "Keeping one's mind and spirit free from evil traits," and "Refraining from damaging behaviors" were important experiences that the mothers used for "Holistic Abstinence." The results provide new information about the subjective experiences of Iranian women on the patterns of abstinence for the midwives, research community, policy makers, and planners of maternal and child health care services in order to contribute to holistic, culturally, and religiously competent prenatal care for Muslim pregnant women throughout the world.

Influence of culture and community perceptions on birth and perinatal care of immigrant women: doulas' perspective

A qualitative study examined the perceptions of doulas practicing in Washington State regarding the influence of cultural and community beliefs on immigrant women's birth and perinatal care, as well as their own cultural beliefs and values that may affect their ability to work interculturally. The findings suggest that doulas can greatly aid immigrant mothers in gaining access to effective care by acting as advocates, cultural brokers, and emotional and social support. Also, doulas share a consistent set of professional values, including empowerment, informed choice, cultural relativism, and scientific/evidence-based practice, but do not always recognize these values as culturally based. More emphasis on cultural self-awareness in doula training, expanding community doula programs, and more integration of doula services in health-care settings are recommended.

Cultural background and socioeconomic influence of immigrant and refugee women coping with postpartum depression

Postpartum depression is a serious condition that can have long lasting traumatic effects on women and their families. Until recently postpartum depression research has focused more on the population as a whole rather than refugee and immigrant women. Informed by Kleinman's explanatory model and the postcolonial feminist perspective, 30 immigrant and refugee women were interviewed to find out what factors influenced them in seeking postpartum care and what strategies would be helpful in prevention and treatment of postpartum depression. We found that the immigrant and refugee women in our sample: (a) were influenced by both cultural background and socioeconomic factors in seeking support and treatment; (b) were influenced by cultural differences and social stigma when making decisions about health care practices; and (c) employed numerous coping strategies to deal with postpartum depression. Recommendations are provided for more culturally appropriate and equitable mental health care services for immigrant and refugee women living in Canada.

Every mother and child count: overcoming invisibility

While statistics document shocking and sobering facts about disparities in women's health and women's quality of life around the world, they do not portray the lives of women individually or recognize the importance of listening to their voices. Reasons for the continuing invisibility of women include issues related to mission, attitudes, evaluation, translation, prevention, integration, empowerment, organization, advocacy and leadership. This article explains the underpinnings of these contributors to women's invisibility and offers readers ways to become more fully engaged in global health initiatives to make women and children more visible.

Global and cultural perinatal nursing research: improving clinical practice

High-quality perinatal nursing care should be based on the best evidence including research findings, clinical expertise, and the preferences of women and their families. Principles of perinatal research initiatives are defined, with suggested research priorities designed to close current gaps in the micro and macro environments of perinatal nursing throughout the world. Nearly a decade ago, the following question was asked, "Where is the 'E' (evidence) in maternal child health?" Improving the quality and safety of perinatal nursing care for culturally diverse women globally is the primary goal of nurse researchers leading the future of perinatal healthcare.