A Study On The Cultural Practices Of Postnatal Mothers In Selected Hospitals At Mangalore

Introduction

Much of the woman's behaviour during the postpartum period is strongly influenced by her cultural background. In today's world, where travel is commonplace, nurses are likely to come in contact with women from many different countries and cultures.

Every society has its own traditional beliefs and practices related to pregnancy and health care. Beliefs in super natural power that is holy rituals, salvation offerings and sacrifices are applied at the different stages of life from birth to death. There are many such practices, rituals, beliefs and offerings which either protect or harm the health of the mother and foetus in utero. Culture influences the way people of a group view themselves, their expectations, and their behaviour in response to certain situations

Providing culturally competent nursing care means that care is planned and implemented in a way that is sensitive to the needs of individuals, families and groups from diverse cultural populations within society. The nurse who recognizes and respects cultural diversity has cultural sensitivity and provides nursing care that accepts the significance of cultural factors in health and illness

Postpartum maternal health care influences the health of both the mothers and their children greatly. Like prenatal care, the postpartum health care that is typically provided during the six-week period after childbirth is very important to the mothers' health.¹In developing countries, over 60% of maternal deaths occur during the postpartum period. Effective postpartum care is essential to maximize survival of mothers and new born regardless of where a woman delivers

India, being a land of diverse cultures and traditions, postpartum care and diet varies, based on topography of the region, culture, tradition and religious practices

Culturally competent care involves knowledge of the various dimensions of care, including moving beyond the biomedical needs of the patient. Rather, a holistic approach is one that expands knowledge. Changes attitudes, and enhances clinical skills. To provide optimal care in a variety of clinical settings, it is important for health care professionals to conduct cultural assessments and expand their knowledge and understanding of culturally influenced beliefs, common health care practices, customs, and rituals.

In conclusion, researcher need to recognize that cultures reflect life experiences; they should be sensitive to cultural differences in postpartum beliefs and practices as the first step toward developing their cultural competence. With these references, the investigator has taken up a study related to cultural practices hence exploring it in the society.

Materials and methods

Research approach: Descriptive survey research approach. Research design: Descriptive designs are designed to gain more information about characteristics within a particular field of study.

Setting: The study was conducted in various hospitals at Mangalore.

Population: The population selected for the study comprises of multiparous postnatal mothers in selected Hospitals at Mangalore.

Sample/Sampling techniques : The purposive sampling technique was adopted to select 200 postnatal mothers.

Instrument/Method of data collection: The tool was used to collect the data 1) Demographic Proforma consists of 7 items which includes age, education, religion, occupation, income, the type of family, and area of residence and 2) structured questionnaire of cultural practices consists of 40 items divided into five sections like Diet, Bath, Spiritual activity, Breast feeding and Baby care.

Analysis: The data was analysed using SPSS version 16.0.

Results were tabulated and depicted graphically.

Statistical Analysis: Frequency distribution and percentage was used for analysis of the result.

Results

Analysis of base line characteristic of subjects revealed that among multiparous postnatal mothers 49% belongs to the age group of 25-29 years, 48.5% of the mothers were having Primary education, 49.5% of the mothers were belongs to Muslim religion, 89% of the participants were homemakers, 65.5% of the mothers belongs to Joint family and 76% of the participants were from rural area.

The item wise distribution of sample according to the cultural practices (diet, bath, spiritual activity, breast feed and baby care) described under different headings.

DIET: The present study shows that, in dietary practices during postnatal period, only few (28%) of the postnatal mothers consumed green leafy vegetables to prevent cold to mother and the baby too. 80.50% of the mothers had practice of drinking kalijira kashayam and 79.5% of the mothers consumed special food (home medicine) to increase breast milk and strengthen the bones and muscles during postnatal period. This food is highly nutritious, contains more of ghee, methi and garlic, which helps to increase the breast milk.

BATH: During the post partum period 52.5% of the mothers were restricted to oil massage before hot water bath for 40 days and 56% of the postnatal mothers were restricted from using cold water for washing hands, taking bath, toilet use and drinking purpose.

SPIRITUAL ACTIVITIES: Majority (84.5%) of the postnatal mothers were restricted to spiritual activities and 87.5% mothers had performed purification ceremony. However, the 65% of people were practicing to keep metal and broom stick under the bed.

BABY CARE: In order to prevent/reduce the cold to the baby, 64% of the postnatal mothers were including the herbs in baby bath. 16.5% of the postnatal mothers have applied the herbal medicine to the cord. However 62% of the postnatal mothers had practiced to dispose the dried cord by burial method. The investigator found that the practice of disposal of dried cord by postnatal mothers in Muslim religion, by 14th day with few hairs of the baby, along with a coin will be kept on the coconut tree or put into the stream of water. The very beginning of the postpartum days the breast milk production will be insufficient. In order to improve the bowel movement of the baby, the postnatal mothers were practicing to give hot water to the baby. The present study showed that 20% of the mothers had practiced to give hot water to the baby. 38% of the mothers had practiced to give home medicine (includes garlic, ginger, pepper and shoot of some selected plants) to the baby to relieve the abdominal discomfort. Application of kajal and use of black thread practice was 99% of the mothers had followed after the naming/purification ceremony to prevent bad eyes. Even though the urine is a source of infection to the baby, 59.5% of the mothers were following unhygienic practice that using a cloth soaked in baby's urine to remove the coated tongue. Although the smoke is not good for health, the 79% of the mothers were had practice of exposing the baby to the dhoopam smoke after bath to protect the baby from evil spirit.

Comparison of cultural practices of postnatal mothers with selected demographic variables.

Age: The major findings identified during the Comparison of the cultural practices with age showed that, 100% of the postnatal mothers with all age groups had a practice of consumption of warm food after delivery whereas 95% of the postnatal mothers of the age group of 30-34 years practiced to drink kalijira (black cumin seed) kashayam for first 3 days after delivery. About 58% of the postnatal mothers of age group of 35-39 years were restricted to drink more water. 89% of the postnatal mothers with age group of 30-34 years had a practice of consuming special food (home prepared) to increase the lactation and strengthen the bones and muscles.

Comparing the cultural practices regarding spiritual activity with different age group revealed that, 96% of the postnatal mothers (20-24 years) were restricted to perform spiritual activities before 40 days, 70% of the postnatal mothers (30-34 years) had a practice of keeping metal and broom stick under the bed. Thirty three percent of the mothers (35-39 years) applied some home medicine to the cord to dry faster, 67% of the postnatal mothers (35-39 years) disposed the cord by burial method. Hundred percent of the postnatal mothers with all the age group practiced the application of Kajal on the baby's face and use of black thread to prevent bad eye after the purification ceremony. 100% of the mothers with an age group 25-29 years practiced to remove coated tongue by using a cloth soaked in baby's urine.

Education : During the comparison of the cultural practices of postnatal mothers with the education, the researcher found that, 100% of the mothers with all the categories of education practiced to consume warm food, 99% of the mothers with primary education drank Kalijira (black cumin-seed) for first 3 days. 84% of the mothers with secondary education consumed special food (home preparation) to increase the lactation and strengthen the bones and muscles.

Hundred percent of the postnatal mothers with no formal education were restricted to perform spiritual activities before 40 days, 71% of the mothers with PUC practiced to keep the metal and broom stick under the bed.

Hundred percent of the mothers with educational qualification of degree & above fed the (colostrums) first milk, 74% of the mothers with primary education buried the cord when it dries and falls. With all the categories of education mothers practiced to apply Kajal on the baby's face and also of tying black thread to prevent bad eye after the purification ceremony. The majority (88%) of mothers with no formal education practiced to remove coated tongue by using a cloth soaked in baby's urine.

Religion: There were significant differences observed in comparison of the cultural practices with the religion that, 100% of the mothers practiced the consumption of warm food after delivery. Majority (97%) of the Hindu postnatal mothers practiced to drink Kalijira kashayam (black cuminseed) for first 3 days. 58% of the Hindus were restricted to drink more water. 92% of the Hindus were consumed special food (home preparation) to increase the lactation and strengthen bones and muscles.

Ninety eight percentages of the Muslim postnatal mothers were restricted to perform spiritual activities before 40 days. Majority (95%) of the Hindu mothers practiced to keep the metal and broom stick under the bed. 18% of the Muslim mothers were applied home medicine and herbal oil to the cord to dry faster. All the religion mothers (100%) were practicing to apply Kajal on the baby's face to prevent bad eye after the purification. 67% of the Muslim mothers were practicing to remove coated tongue by using a cloth soaked in baby's urine.

Occupation: The result of comparison of the cultural practices during postnatal period with the occupation showed that, 100% of the mothers practiced to consume warm food. The majority (96%) of the home makers were drinking Kalijira (black cumin-seed) for first 3 days, 47% were restricted to drink more water, 81% were consuming special food (home medicine) to increase lactation and to strengthen the bones and muscles, 91% were restricted to perform spiritual activities, 66% were keeping metal and broom stick under the bed to prevent evil spirit and 66% have buried the cord when it dries and falls during the postnatal period.

Hundred percent of the private employees applied Kajal on the baby's face and tied black thread around the waist to prevent bad eye. 64%of the home makers removed coated tongue by using a cloth soaked in baby's urine.

Family: The findings of the cultural practices compared with different types of families showed that, the majority (95%) of the mothers from joint family were drinking Kalijira (black cumin-seed) for first 3 days. 47% of the mothers from the joint family were restricted to drink more water. 84% of the mothers from nuclear family practiced to consume special food (home preparation) to increase lactation and to strengthen the bones and muscles.

Ninety one percent of the mothers from joint family were restricted to perform spiritual activities. Majority (93%) of the mothers from nuclear family were practiced to keep metal and broom stick under the bed, 64% of the mothers from the nuclear family have applied home medicine to the cord dry faster. 66% of the mothers from joint family had a practice of burial the cord. The majority (99%) of the mothers from nuclear family were practicing to expose the baby to the dhoopam smoke after the bath.

The 100% of the mothers from nuclear family practiced to apply Kajal on the baby's face and tied black thread to prevent bad eye and also practiced to remove the coated tongue by using a cloth soaked in baby's urine.

Area of residence : The comparison of cultural practices with area of residence showed that, 100% of rural and urban postnatal mothers were practicing the consumption of warm food after delivery. Majority (95%) of the rural mothers were practicing to drink Kalijira (black cuminseed) for first 3 days, 46% of the rural mothers were restricted to drink more water. Majority (87%) of the urban mothers consumed special food (home preparation) for increased lactation and to strengthen the bones and muscles.

The 73% of the urban mothers practiced oil massage before bath during postnatal period. The majority (96%) of the rural mothers were restricted to perform spiritual activities, 66% were practiced to keep metal and broom stick under the bed, 15% were applied home medicine to the cord to dry faster and 68% were buried the cord when it dries and falls. The 100% of the urban mothers applied Kajal and tied black thread to the baby for prevention of bad eye. The majority (68%) of the rural mothers practiced to remove the coated tongue by using a cloth soaked in baby's urine.

Discussion

To achieve the objectives of the study a descriptive survey approach was considered. Non-probability purposive sampling technique was used to select the samples. The data was collected from 200 postnatal multiparous women in selected hospitals at Mangalore.

The findings of the study were discussed under following sections;

• Section-A: classification of demographic variables

• Section-B: assessment of cultural practices of postnatal mothers.

• Section-C: comparison of cultural practices with the demographical variables.

Conclusion

Generally, women and their newborn are secluded from the rest of the household to limit contamination from the polluting powers of 'after-birth'. This is widely practiced across India, and is an intrinsic part of women's daily lives in traditional societies. Health professionals should be aware of the patient's culture and which traditional belief complements professional care. Healthcare providers should also advice and educate women about and importance of adhering to the standard practice of postpartum care while outlining appropriate strategies for integration of mother's traditional beliefs and modern approaches of postpartum care.