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Kothari A, Khuu A, Dulhunty J, Bruxner G, Ballard E, Callaway L. Fathers attending the birth of their baby: Views, intentions and needs. Aust N Z J Obstet Gynaecol 2023; 63:689-695. [PMID: 37145387 DOI: 10.1111/ajo.13692] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 04/10/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND There is limited information about fathers' views, intentions and needs leading up to childbirth. AIMS This study explores the factors influencing fathers' intention to attend the birth, and the needs and supports required leading up to childbirth. METHODS Cross-sectional survey of 203 prospective fathers attending antenatal appointments at an outer metropolitan public teaching hospital in Brisbane, Australia. RESULTS A total of 201/203 (99.0%) participants intended to attend the birth. The reported reasons included: responsibility (99.5%), protectiveness (99.0%), love for their partner (99.0%), the right thing to do (98.0%), desire to see the birth (98.0%), the perception that partners should attend (97.4%), duty (96.4%) and partner preference (91.4%). Some felt pressured by their partner (12.8%), society (10.8%), cultural expectations (9.6%) and family (9.1%), and 10.6% perceived adverse consequences for not attending. Most participants (94.6%) felt well supported, experienced good communication (72.4%), had the opportunity to ask questions (69.8%) and received an explanation of events (66.3%). They were less often supported by antenatal visits (46.7%) and by a plan for future visits (32.2%). Ten per cent of all fathers and 13.8% of experienced fathers requested better mental health support, and 9.0% prefer better clinician communication. CONCLUSIONS Most fathers intend to attend childbirth for personal and moral reasons; however, a small proportion feel pressured. Most fathers feel well supported, although potential improvements include planning for future visits, provision of information, mental health support, clinician communication, increased involvement in their partner's care, the opportunity to ask questions and more frequent clinic visits.
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Affiliation(s)
- Alka Kothari
- Department of Obstetrics and Gynaecology, Redcliffe Hospital, Redcliffe, Queensland, Australia
- Faculty of Medicine, The University of Queensland, St Lucia, Queensland, Australia
| | - Alvin Khuu
- Department of Obstetrics and Gynaecology, Redcliffe Hospital, Redcliffe, Queensland, Australia
- Faculty of Medicine, The University of Queensland, St Lucia, Queensland, Australia
| | - Joel Dulhunty
- Department of Obstetrics and Gynaecology, Redcliffe Hospital, Redcliffe, Queensland, Australia
- Faculty of Medicine, The University of Queensland, St Lucia, Queensland, Australia
| | - George Bruxner
- Metro-North Mental Health Service, Caboolture Hospital, Caboolture, Queensland, Australia
| | - Emma Ballard
- QIMR Berghofer Medical Research Institute, Brisbane, Herston, Queensland, Australia
| | - Leonie Callaway
- Faculty of Medicine, The University of Queensland, St Lucia, Queensland, Australia
- Women's and Newborns Services, The Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
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Wilson AN, Melepia P, Suruka R, Hezeri P, Kabiu D, Babona D, Wapi P, Morgan A, Vogel JP, Beeson J, Morgan C, Kelly-Hanku A, Scoullar MJL, Nosi S, Vallely LM, Kennedy E, Bohren MA, Homer CSE. Community perspectives and experiences of quality maternal and newborn care in East New Britain, Papua New Guinea. BMC Health Serv Res 2023; 23:780. [PMID: 37474934 PMCID: PMC10360243 DOI: 10.1186/s12913-023-09723-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 06/16/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Quality maternal and newborn care is essential for improving the health of mothers and babies. Low- and middle-income countries, such as Papua New Guinea (PNG), face many barriers to achieving quality care for all. Efforts to improve the quality of maternal and newborn care must involve community in the design, implementation, and evaluation of initiatives to ensure that interventions are appropriate and relevant for the target community. We aimed to describe community members' perspectives and experiences of maternal and newborn care, and their ideas for improvement in one province, East New Britain, in PNG. METHODS We undertook a qualitative descriptive study in partnership with and alongside five local health facilities, health care workers and community members, using a Partnership Defined Quality Approach. We conducted ten focus group discussions with 68 community members (identified through church, market and other community-based groups) in East New Britain PNG to explore perspectives and experiences of maternal and newborn care, identify enablers and barriers to quality care and interventions to improve care. Discussions were transcribed verbatim. A mixed inductive and deductive analysis was conducted including application of the World Health Organisation (WHO) Quality Maternal and Newborn Care framework. RESULTS Using the WHO framework, we present the findings in accordance with the five experience of care domains. We found that the community reported multiple challenges in accessing care and facilities were described as under-staffed and under resourced. Community members emphasised the importance of good communication and competent, caring and respectful healthcare workers. Both women and men expressed a strong desire for companionship during labor and birth. Several changes were suggested by the community that could immediately improve the quality of care. CONCLUSIONS Community perspectives and experiences are critical for informing effective and sustainable interventions to improve the quality of maternal and newborn care and increasing facility-based births in PNG. A greater understanding of the care experience as a key component of quality care is needed and any quality improvement initiatives must include the user experience as a key outcome measure.
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Affiliation(s)
- Alyce N Wilson
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia.
- School of Population and Global Health, Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia.
| | - Pele Melepia
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
- Healthy Mothers, Healthy Babies, Burnet Institute, Kokopo, Papua New Guinea
| | - Rose Suruka
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
- Healthy Mothers, Healthy Babies, Burnet Institute, Kokopo, Papua New Guinea
| | - Priscah Hezeri
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
- Healthy Mothers, Healthy Babies, Burnet Institute, Kokopo, Papua New Guinea
| | - Dukduk Kabiu
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
- Healthy Mothers, Healthy Babies, Burnet Institute, Kokopo, Papua New Guinea
| | | | - Pinip Wapi
- Nonga General Hospital, Rabaul, Papua New Guinea
| | - Alison Morgan
- Global Financing Facility, World Bank, Washington, DC, USA
| | - Joshua P Vogel
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | - James Beeson
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
- Department of Medicine, University of Melbourne, Melbourne, Australia
| | | | - Angela Kelly-Hanku
- Papua New Guinea Institute for Medical Research, Goroka, Papua New Guinea
- Kirby Institute, University of New South Wales, Kensington, Australia
| | - Michelle J L Scoullar
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
- Department of Medicine, University of Melbourne, Melbourne, Australia
| | - Somu Nosi
- Papua New Guinea Institute for Medical Research, Goroka, Papua New Guinea
| | - Lisa M Vallely
- Papua New Guinea Institute for Medical Research, Goroka, Papua New Guinea
- Kirby Institute, University of New South Wales, Kensington, Australia
| | - Elissa Kennedy
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | - Meghan A Bohren
- Gender and Women's Health Unit, School of Population and Global Health, Centre for Health Equity, University of Melbourne, Melbourne, Australia
| | - Caroline S E Homer
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
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Goutaudier N, Séjourné N. Post-partum post-traumatic stress disorder in fathers: Issues and prospects. L'ENCEPHALE 2023; 49:314-316. [PMID: 37088576 DOI: 10.1016/j.encep.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 04/25/2023]
Affiliation(s)
- Nelly Goutaudier
- Centre de Recherches sur la Cognition et l'Apprentissage, CeRCA-UMR CNRS 7295, Université de Poitiers, Poitiers, France.
| | - Natalène Séjourné
- Centre d'Études et de Recherches en Psychopathologie et Psychologie de la Santé - CERPPS EA 7411, Université de Toulouse Jean-Jaurès, Toulouse, France
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Uhawenimana TC, Gray NM, Whitford H, McFadden A. Development and early validation of questionnaires to assess system level factors affecting male partners' attendance at childbirth in LMICs. BMC Pregnancy Childbirth 2023; 23:258. [PMID: 37069553 PMCID: PMC10108494 DOI: 10.1186/s12884-023-05580-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 04/07/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND There is evidence that a woman who receives continuous labour support from a chosen companion can have shorter labour duration, is more likely to give birth without medical interventions, and report a satisfying childbirth experience. These outcomes result from the beneficial effects of emotional and practical support from the woman's chosen companion, and care provided by health providers. When a woman's chosen companion is her male partner, in addition to the above benefits, his presence can promote his bonding with the baby, and shared parenthood. However, there may be healthcare system barriers, including organisational, management and individual (staff) factors, that inhibit or restrict women's choice of companion. There are currently no suitable survey tools that can be used to assess the system level factors affecting the implementation of male partners' attendance at childbirth in low- and middle- income countries (LMICs). METHODS We designed two questionnaires to help to address that gap: the Male Partners' Attendance at Childbirth-Questionnaire for Heads of Maternity Units (MPAC-QHMUs); and the Male Partners' Attendance at Childbirth-Questionnaire for Maternity Staff (MPAC-QMS). We carried out an extensive review to generate initial items of the two questionnaires. We assessed the content and face validity of the two questionnaires in a three-round modified Delphi study. RESULTS The Male Partners' Attendance at Childbirth-Questionnaire for Heads of Maternity Units (MPAC-QHMUs) focused on organisational and management factors. The Male Partners' Attendance at Childbirth-Questionnaire of Maternity Staff (MPAC-QMS) focused on individual staff factors. The final MPAC-QHMUs and MPAC-QMS included items which garnered over 80% content relevance according to the experts' rating. After all three consensus rounds of the Delphi study, 43 items were retained for the MPAC-QHMUs and 61 items were retained for the MPAC-QMS. CONCLUSIONS The MPAC-QHMUs and the MPAC-QMS may help understanding of barriers affecting male partners' attendance at childbirth in LMICs in order to devise implementation strategies to enable wider availability and to maximize women's choices during labour and childbirth. The MPAC-QHMUs and the MPAC-QMS as newly-developed questionnaires require further validation of their acceptability and feasibility in different cultural contexts, and languages.
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Affiliation(s)
- Thierry Claudien Uhawenimana
- College of Medicine and Health Sciences, School of Nursing and Midwifery, Department of Midwifery, University of Rwanda, Po. Box: 3286, Kigali, Rwanda.
| | - Nicola M Gray
- School of Health Sciences, University of Dundee, Dundee, DD1 4HJ, Scotland, UK
| | - Heather Whitford
- School of Health Sciences, University of Dundee, Dundee, DD1 4HJ, Scotland, UK
| | - Alison McFadden
- School of Health Sciences, University of Dundee, Dundee, DD1 4HJ, Scotland, UK
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Corazza I, Ferrari A, Bonciani M, Corazza I. Effectiveness of measures to preserve labour and childbirth companionship at the times of COVID-19 outbreak. Health Policy 2023; 129:104703. [PMID: 36642625 PMCID: PMC9769027 DOI: 10.1016/j.healthpol.2022.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Although childbirth services were accessible after COVID-19 outbreak, the measures taken by the Italian Government for contagion containment required some restrictions on the presence of trusted persons for mothers, forcing them to isolation during hospitalization. To preserve companionship, the Regional Health Authority of Tuscany issued a resolution providing partners with the possibility to be present during labour and childbirth for non-asymptomatic women. OBJECTIVES In this study, we: 1) analyse the impact of pandemic on companionship in terms of significant reduction of the possibility for women to be accompanied by a trusted person during labour and childbirth; and 2) ascertain if the regional resolution issued was effective in containing the reduction of companionship. METHODS We performed an interrupted time series analysis to measure the variation of the possibility for women to be accompanied by a trusted person during labour and childbirth, in response to formalization of lock-down due to COVID-19 outbreak and the introduction of the regional resolution aimed at contrasting negative effects on companionship. RESULTS AND CONCLUSIONS The ITS analysis showed that there was a significant decrease in the women-reported experience of companionship in the month of the formalization of lock-down, namely March 2020, followed by a slight increase in the upcoming months. A trend reversal was observed after May 2020, when the regional resolution was fully operational.
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Affiliation(s)
- Ilaria Corazza
- Management and Health Laboratory, Institute of Management, Scuola Superiore Sant'Anna, Via S. Zeno, 2, Pisa, PI 56127, Italy.
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Leahy-Warren P, Philpott L, Elmir R, Schmied V. Fathers' perceptions and experiences of support to be a parenting partner during the perinatal period: A scoping review. J Clin Nurs 2022. [PMID: 35898120 DOI: 10.1111/jocn.16460] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/13/2022] [Accepted: 07/05/2022] [Indexed: 10/16/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study was to explore fathers' perceptions and experiences of support in the perinatal period. Change in society has seen the increased visibility of fathers being involved during pregnancy and engaging in their infants' lives and the expectation and benefits of men playing an equal and direct role in caring for their children. However, less is known about the nature of support that fathers require to facilitate this role transition. DESIGN A scoping review was conducted in accordance with Arksey and O'Malley's six-step scoping review framework and the PRISMA-ScR guidelines. METHODS A systematic search of CINAHL Plus, MEDLINE, the Cochrane Library, PsycARTICLES, PsycINFO, Psychology, Soc INDEX and Behavioural Sciences Collections databases for qualitative or mixed methods studies with qualitative data was undertaken. Qualitative data were extracted from original studies for coding and theme generation. Thematic synthesis was employed for the final stages of analysis. RESULTS Overall, 23 papers were included. Men desired to fulfil their rite of passage to be an involved father to their child. This transitional process commenced with men articulating their commitment to creating a role as an involved father and to be a role model for their children. Becoming a father is seen as having a significant status in society which contributes to their self-efficacy as fathers. CONCLUSION Fathers require support from all levels of the 'ecosystem' including policy, socio-cultural and workplace changes as well as recognition and support from partners, family, peers and in particular from health service providers. Developing the parenting partnership requires a co-production approach and commitment at macro, meso and micro levels. RELEVANCE TO CLINICAL PRACTICE Supporting men to be engaged fathers requires policy, socio-cultural and workplace changes; however, maternity services and particularly midwives have an important role in this change.
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Affiliation(s)
| | - Lloyd Philpott
- School of Nursing and Midwifery, University College, Cork, Ireland
| | - Rakime Elmir
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
| | - Virginia Schmied
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
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Al Tarawneh T, Shoqirat N, Almalik M. "Being relieved and puzzled": A qualitative study of first time fathers' experiences postpartum in Jordan. Women Birth 2019; 33:e320-e325. [PMID: 31371178 DOI: 10.1016/j.wombi.2019.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 07/12/2019] [Accepted: 07/12/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Although the transition to fatherhood is a point of attention for researchers, little is known about the first time father's postpartum experience. This study aims to explore the first time fathers postpartum experience in the country of Jordan. METHODS An exploratory qualitative design was used. Semi-structured interviews were conducted with a purposive sample consisting of twelve first time fathers. The study was conducted in a public university in Jordan. The data was collected in 2017 and was thematically analysed using the colour and file index method. RESULTS The analysis revealed two main themes. The first theme centred around a feeling of relief which can be further divided into two sub-themes of self-actualisation and continuation of the family line. The second theme centred around the feeling of puzzlement, and this can also be further divided into two sub-themes of feeling unable to deal with a newborn baby and struggling to care for a recovering wife. The study identified fathers as willing to engage in the private care of their new babies and recovering wives but at a limited level of engagement. The fathers verbalised the lack of knowledge and exhibited sociocultural stereotypes related to masculinity and the role of the man in the family. CONCLUSIONS The first time fathers' experiences ranged from feelings of relief to puzzlement. The fathers experiences were shaped by religion, culture, and masculinity which suggests education during antepartum may enhance the experience.
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Affiliation(s)
- Tamador Al Tarawneh
- Maternal and Child Health Nursing Department, Faculty of Nursing, University of Mutah, P.O. Box 7, Al-Karak 61710, Jordan.
| | - Noordeen Shoqirat
- Adult Health Nursing, Nursing Faculty, Mutah University, Karak, 61710, Jordan.
| | - Mona Almalik
- Maternal and Child Health Nursing Department, Faculty of Nursing, University of Mutah, P.O. Box 7, Al-Karak 61710, Jordan.
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Bohren MA, Berger BO, Munthe‐Kaas H, Tunçalp Ö. Perceptions and experiences of labour companionship: a qualitative evidence synthesis. Cochrane Database Syst Rev 2019; 3:CD012449. [PMID: 30883666 PMCID: PMC6422112 DOI: 10.1002/14651858.cd012449.pub2] [Citation(s) in RCA: 110] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Labour companionship refers to support provided to a woman during labour and childbirth, and may be provided by a partner, family member, friend, doula or healthcare professional. A Cochrane systematic review of interventions by Bohren and colleagues, concluded that having a labour companion improves outcomes for women and babies. The presence of a labour companion is therefore regarded as an important aspect of improving quality of care during labour and childbirth; however implementation of the intervention is not universal. Implementation of labour companionship may be hampered by limited understanding of factors affecting successful implementation across contexts. OBJECTIVES The objectives of the review were to describe and explore the perceptions and experiences of women, partners, community members, healthcare providers and administrators, and other key stakeholders regarding labour companionship; to identify factors affecting successful implementation and sustainability of labour companionship; and to explore how the findings of this review can enhance understanding of the related Cochrane systematic review of interventions. SEARCH METHODS We searched MEDLINE, CINAHL, and POPLINE K4Health databases for eligible studies from inception to 9 September 2018. There were no language, date or geographic restrictions. SELECTION CRITERIA We included studies that used qualitative methods for data collection and analysis; focused on women's, partners', family members', doulas', providers', or other relevant stakeholders' perceptions and experiences of labour companionship; and were from any type of health facility in any setting globally. DATA COLLECTION AND ANALYSIS We used a thematic analysis approach for data extraction and synthesis, and assessed the confidence in the findings using the GRADE-CERQual approach. We used two approaches to integrate qualitative findings with the intervention review findings. We used a logic model to theorise links between elements of the intervention and health and well-being outcomes. We also used a matrix model to compare features of labour companionship identified as important in the qualitative evidence synthesis with the interventions included in the intervention review. MAIN RESULTS We found 51 studies (52 papers), mostly from high-income countries and mostly describing women's perspectives. We assessed our level of confidence in each finding using the GRADE-CERQual approach. We had high or moderate confidence in many of our findings. Where we only had low or very low confidence in a finding, we have indicated this.Labour companions supported women in four different ways. Companions gave informational support by providing information about childbirth, bridging communication gaps between health workers and women, and facilitating non-pharmacological pain relief. Companions were advocates, which means they spoke up in support of the woman. Companions provided practical support, including encouraging women to move around, providing massage, and holding her hand. Finally, companions gave emotional support, using praise and reassurance to help women feel in control and confident, and providing a continuous physical presence.Women who wanted a companion present during labour and childbirth needed this person to be compassionate and trustworthy. Companionship helped women to have a positive birth experience. Women without a companion could perceive this as a negative birth experience. Women had mixed perspectives about wanting to have a male partner present (low confidence). Generally, men who were labour companions felt that their presence made a positive impact on both themselves (low confidence) and on the relationship with their partner and baby (low confidence), although some felt anxious witnessing labour pain (low confidence). Some male partners felt that they were not well integrated into the care team or decision-making.Doulas often met with women before birth to build rapport and manage expectations. Women could develop close bonds with their doulas (low confidence). Foreign-born women in high-income settings may appreciate support from community-based doulas to receive culturally-competent care (low confidence).Factors affecting implementation included health workers and women not recognising the benefits of companionship, lack of space and privacy, and fearing increased risk of infection (low confidence). Changing policies to allow companionship and addressing gaps between policy and practice were thought to be important (low confidence). Some providers were resistant to or not well trained on how to use companions, and this could lead to conflict. Lay companions were often not integrated into antenatal care, which may cause frustration (low confidence).We compared our findings from this synthesis to the companionship programmes/approaches assessed in Bohren's review of effectiveness. We found that most of these programmes did not appear to address these key features of labour companionship. AUTHORS' CONCLUSIONS We have high or moderate confidence in the evidence contributing to several of these review findings. Further research, especially in low- and middle-income settings and with different cadres of healthcare providers, could strengthen the evidence for low- or very low-confidence findings. Ahead of implementation of labour companionship, researchers and programmers should consider factors that may affect implementation, including training content and timing for providers, women and companions; physical structure of the labour ward; specifying clear roles for companions and providers; integration of companions; and measuring the impact of companionship on women's experiences of care. Implementation research or studies conducted on labour companionship should include a qualitative component to evaluate the process and context of implementation, in order to better interpret results and share findings across contexts.
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Affiliation(s)
- Meghan A Bohren
- World Health OrganizationUNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research20 Avenue AppiaGenevaGeneveSwitzerland1211
- University of MelbourneCentre for Health Equity, Melbourne School of Population and Global HealthLevel 4, 207 Bouverie StreetCarltonVictoriaAustralia3053
| | - Blair O Berger
- Johns Hopkins Bloomberg School of Public HealthDepartment of Population, Family and Reproductive HealthBaltimoreMarylandUSA
| | | | - Özge Tunçalp
- World Health OrganizationUNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research20 Avenue AppiaGenevaGeneveSwitzerland1211
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Raman S, Nicholls R, Ritchie J, Razee H, Shafiee S. How natural is the supernatural? Synthesis of the qualitative literature from low and middle income countries on cultural practices and traditional beliefs influencing the perinatal period. Midwifery 2016; 39:87-97. [DOI: 10.1016/j.midw.2016.05.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Revised: 05/03/2016] [Accepted: 05/07/2016] [Indexed: 11/26/2022]
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Raman S, Nicholls R, Ritchie J, Razee H, Shafiee S. Eating soup with nails of pig: thematic synthesis of the qualitative literature on cultural practices and beliefs influencing perinatal nutrition in low and middle income countries. BMC Pregnancy Childbirth 2016; 16:192. [PMID: 27464710 PMCID: PMC4964025 DOI: 10.1186/s12884-016-0991-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 07/23/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The perinatal period, i.e. pregnancy, childbirth and early infancy, is a significant transition period where the biological and the social strongly intersect. In low and middle-income countries the disease burden arising from the perinatal period, is still substantial. The perinatal period is also a crucial window of opportunity for reducing undernutrition and its long term adverse effects. METHODS We explored qualitative research conducted in low resource settings around the perinatal continuum over the past two decades, with a particular focus on the 'cultural' realm, to identify common themes influencing maternal and infant nutrition. We systematically searched electronic databases from 1990 to 2014, including MEDLINE, EMBASE, PsycINFO, Scopus and Cumulative Index to Nursing and Allied Health Literature, using relevant search terms including traditional beliefs, practices, pregnancy, childbirth, developing countries etc. Adapted Consolidated Criteria for Reporting Qualitative Health Research and Critical Appraisal Skills Programme criteria were used to determine quality of studies. We synthesised the literature thematically, enabled by NVivo 10 software. RESULTS Most studies showed cultural support for breastfeeding, although most traditional societies delayed breastfeeding due to colostrum being considered 'dirty'. A range of restrictive practices through pregnancy and the post- partum period were revealed in Asia, Latin America and Africa. There was a strong cultural understanding of the healing power of everyday foods. A wide range of good foods and bad foods continued to have currency through the perinatal continuum, with little consensus between groups of what was beneficial versus harmful. Cross-cutting themes that emerged were 1) the role of the woman/mother/wife as strong and good; 2) poverty restricting women's nutrition choices; 3) change being constant, but the direction of change unpredictable. CONCLUSIONS A rich and diverse repertoire of cultural practices and beliefs influenced perinatal nutrition. Results from this synthesis should influence public health policymakers and practitioners, to tailor contextually specific, culturally responsive perinatal nutrition interventions to optimise health and wellbeing of mother-infant dyads. Ideally these interventions should build on culturally sanctioned life affirming behaviours such as breastfeeding, promoting post-partum rest and recovery, while modifying the potentially harmful aspects of other cultural practices in the perinatal period.
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Affiliation(s)
- Shanti Raman
- School of Public Health & Community Medicine, University of New South Wales, & South Western Sydney Local Health District, Health Services Building Level 3, Cnr Campbell & Goulburn St, Liverpool, NSW, 2170, Australia.
| | - Rachel Nicholls
- Faculty of Health, University of Technology, Sydney Level 7, 235 Jones St, Ultimo, NSW, 2007, Australia
| | - Jan Ritchie
- School of Public Health & Community Medicine, University of New South Wales, Samuels Building, Gate 11, Botany Street, Randwick, UNSW, Sydney, NSW, 2052, Australia
| | - Husna Razee
- School of Public Health & Community Medicine, University of New South Wales, Samuels Building, Gate 11, Botany Street, Randwick, UNSW, Sydney, NSW, 2052, Australia
| | - Samaneh Shafiee
- School of Public Health & Community Medicine, University of New South Wales, Samuels Building, Gate 11, Botany Street, Randwick, UNSW, Sydney, NSW, 2052, Australia
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