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  1. 1. Cultural Sensitivity in Maternal and Child CareObservance of the laws of kashrut, the laws of nidah, the laws of tzniutand all the commandments of the Torah bring spirituality to this physicalworld. We believe that the entire universe was created to bring the gloryof G-d and His will from the highest heavens down to the mundane worldwe live in, thereby giving all things physical, a spiritual significance.
  2. 2. "I have some real concerns about this couple.Although they attended childbirth preparationclasses, the father wasnt physically supportive of hiswife. Oh, he was verbally supportive, but he wouldnttouch her at all, not hand-holding or back-rubbing!Any time we checked his wife or gave her physicalcare, he left the room and didnt return until wecalled him back. He refused to enter the deliveryroom, too! He stayed in the labor room reading! Inthe recovery room, he kept his distance. None of thehugging and kissing we usually see after the birth.They both say theyre happy with the baby and yetthey wont call her by name."
  3. 3. * Provide a long-sleeved gown that the mother can wear with theopening in front, covering her back.* Rationale: Orthodox women generally choose clothing that coverstheir elbows and knees.* Permit the mother to wear her hair covering and/or provide abouffant-style operating room cap.* Rationale: Women should cover their hair with a wig, scarf orother head covering.* Give the father the opportunity to leave the room during care andexams in which his wifes body will be exposed.* Husband should not be present during delivery. He may enter whenwife is fully draped* Assist the laboring woman in maintaining head coverage; elbows,knees, or anything possible is to remain covered as much as possible* Rationale: Jewish men, despite their intimate relationship withtheir wives, do not directly observe their wives while they areimmodestly exposed, maintaining their wifes dignity
  4. 4. * Encourage the fathers non-physical coaching efforts such as eye-to-eyecontact, verbal support, or prayer. Once the husband stops providingphysical care, the nurse steps in, applying back counter-pressure, checkingrelaxation, sponging the mother or applying compresses, and stroking ormassaging the mother.* In place of the father, allow the presence of female labor companion, ifthe mother desires.* Rationale: Rabbis interpret the law to mean that niddah is signaled bythe onset of regular uterine contractions, others at the appearance of"bloody show" or membrane rupture.* Niddah is the time the couple refrains from sexual relations and tactileaffection
  5. 5. * Make sure that kosher meals have been ordered for the mother.* Rationale: understanding and respect given by hospital staff can only help theobservant patient feel comfortable in her surroundings and enable her to focus herenergies on getting strong and well.* Permit the mother to eat food brought from home to supplement hospital meals, if herdiet allows.* Set aside a separate refrigerator in the lounge area or in her room so that she can storeher own food.* Rationale: Jews who observe the kosher laws do not eat meat and dairy during thesame meal or use the same plates.* Provide basin, water pitcher and cup so that the mother confined to bed rest can washher hands before each meal.* consult with the mother, her family and the hospital dietician to assess and plan forpostpartum nutritional needs.* Rationale: Before eating bread, the mother washes her hands. Before and after sheeats she recites blessings
  6. 6. * Shir HaMaalos (Psalm 121) is hung in the room of the new mother and thenewborn immediately upon the expectant mother’s arrival at the hospital.* Serves as a safeguard for the mother, both during the birth and during thefollowing days, so that they will live a long life.Psalm 1211 I lift up my eyes to the mountains—where does my help come from?2 My help comes from the Lord,the Maker of heaven and earth.3 He will not let your foot slip—he who watches over you will not slumber;4 indeed, he who watches over Israelwill neither slumber nor sleep.5 The Lord watches over you—the Lord is your shade at your right hand;6 the sun will not harm you by day,nor the moon by night.7 The Lord will keep you from all harm—he will watch over your life;8 the Lord will watch over your coming andgoingboth now and forevermore.
  7. 7. * For the first 72 hours after birth, a woman is considered to be in thecategory of someone who is seriously ill.* Anything that needs to be done for her is permissible:* Allowed to eat on Yom Kippur (the Day of Atonement where Jews fast for 25hours).* Shabbat (Sabbath) may be dishonored if there is no other way to meet her needsduring that time.* On Shabbat, use of electricity and writing is prohibited; In terms ofhospital stay this includes:* A. Call button* B. Lights* C. Phone* D. Automatic doors* E. Television* F. Automatic bed adjustment* G. No forms can be completed, therefore discharge will be delayed until after theholiday* A non-Jewish nurse can ensure patient comfort by:* Adjusting bed* Turning lights off/on* Opening doors
  8. 8. * G-d commanded the Jewish people (Leviticus 12:2), “On the eighth day, the flesh of hisforeskin shall be circumcised.” The act of circumcision, marking the completion of the body,is a human act. This teaches us that our spiritual, emotional, moral and ethical perfectionrequires human effort. G-d cannot do it for us.* The brit milah of a healthy baby is always done on the 8th day, even Shabbat or Yom Kippur,and only during daylight hours! This 8th day is calculated to include the day of birth. If a babyis born, for example, on a Tuesday afternoon, under normally circumstances the Brit would bethe following Tuesday, any time during the day. (There is a tradition to do the Brit as early inthe day as possible.) A Brit Milah performed prior to this 8th day, or at night, does not complywith Jewish law, and is not considered a valid Brit* The father of the infant stands next to the mohel, the one who will perform the circumcision.The father picks up the surgical knife and hands it to the mohel, stating that he appoints themohel as his deputy to perform the brit milah, the circumcision.1 The knife is extremelysharp, and double edged, in order to cause the least pain possible.* The Sephardic custom is for the mohel to say, at this point in the ceremony, “bereshut moireiverabotai,” “with the permission of my teachers and the community.” The communityresponds, “l’chaim,” “to life.”* The mohel recites the blessing, “Blessed are You, L-rd our G-d, King of the universe, Who hassanctified us with His commandments and commanded us concerning circumcision.”* Then he begins the circumcision.
  9. 9. *http://www.youtube.com/watch?feature=player_detailpage&v=qb-hbcDcepY*http://www.youtube.com/watch?feature=player_detailpage&v=qb-hbcDcepY
  10. 10. * In the Torah it says that G-d changed Abrahams name from Avram to Avraham at the time ofhis circumcision. In keeping with that tradition, a Jewish boy is given his Hebrew name at thetime of his Brit Milah. Judaism places a great deal of significance on a childs Hebrew name. Itis often customary to name the child after someone who led a righteous life so that the childwill try to emulate that individual. Ashkenazi Jews often name their children after a dearlydeparted relative, while Sephardic Jews sometimes name their children in honour of livingrelatives. In the case of someone who died at a young age, another name referring to life, orthe name of a person who lived a full life is added.* May He who blessed our fathers, Abraham, Isaac and Jacob, Moses and Aaron, David andSolomon, bless this tender infant (babys Hebrew name) and send him a complete recovery,because he has enter the covenant , just as he entered the covenant, so may he entered intoTorah, to marriage canopy, and to good deeds; and let us say, Amen*In Hebrew
  11. 11. *Jewish girls are named only on Mondays,Thursdays or Shabbat – the days the Torah isread during the prayers.*Baby boys are named only at the brit milah –circumcision ceremony performed on theeighth day from birth.*The birth certificate is often sent to theparents with just “Baby Boy/Baby Girl” inplace of the name and parents then submit thename at a later date and have it added to thelegal papers.
  12. 12. *Women consider a large family to be thebiggest blessing*Procreation is a valued principle of marriage*Only female contraception is allowed*Methods are determined with advice of therabbi*Abortion is only allowed if pregnancy permitsdanger to mother or is result of rape or incest*In a multiple pregnancy, one fetus may beterminated to allow others to develop healthily
  13. 13. *observant menand women do notshake hands orphysically touch amember of theopposite genderwho is not a closeblood relative
  14. 14. A nurse is preparing to deliver a food tray to clientwhose religion is Jewish. The nurse checks the foodon the tray and notes that the client has receivedroast beef dinner with whole milk as beverage. Whichaction will the nurse take?*A. deliver the food tray to the client*B. call the dietary department and ask for new mealtray*C. replace the whole milk with fat-free milk*D. ask the dietary department to replace the roastbeef with pork
  15. 15. *Answer: B*the diet for Jewish people is Kosher diet. Meatand milk combination, pork, and scavengerfishes are prohibited. The appropriate nursingaction is to call the dietary department tochange the meal tray of the patient
  16. 16. You are caring for a Jewish patient on Shabbat. Inwhat ways can you help meet her needs? Select allthat apply.*A. turn off the lights when patient wants to rest*B. ask the patient to use her call light if she needsanything*C. adjusting the bed*D. ensure dietary needs are met*E. ask the patient to sign discharge papers
  17. 17. *Answers: A, C, D, E*Electricity, writing, and anything consideredwork is prohibited on the shabbat. Asking thepatient to use her call bell would bedisrespecting this practice. In an emergency,the practices would be overlooked.
  18. 18. In Judaism, a minor surgical removal of the skin coveringthe tip of the penis is ritually performed when a boy is_______ old in a ceremony called a brit milah, brit, orbriss, which indicates that the ritual establishes acovenant between God and the individual.A) 1 hour oldB) 2 days oldC) 3 months oldD) 8 days old
  19. 19. Answer: DRationale: Throughout the generations, at the age of eight days, everymale child must be circumcised. The Jewish ceremony of circumcisionis known as a brit milah, or brit or briss for short. "At the age ofeight days every male among you shall be circumcised, throughoutyour generations ..." (Genesis 17:12) From this passage comes thesource of the ritual of circumcising a Jewish boy on his eighth day oflife. This date is only altered in circumstances of sickness, in whichcase the circumcision is postponed until the baby is fit enough toendure the operation without ill effect.
  20. 20. A ______________ is a Jewish ritual circumciser. The ceremonyusually takes place in the baby boy’s home, and should be donein the presence of at least ten Jewish men.A) PriestB) SanghaC) MohelD) Swami
  21. 21. Answer: CA Jewish boy is circumcised by a person called a mohel, a ritualcircumciser. This man may also be a physician who is acquaintedwith the Jewish laws of circumcision. The ceremony usually takesplace in the baby boy’s home, and should be done in the presenceof at least ten Jewish men. This enables prayers to be recited, asa group of ten men, called a minyan, is the minimum requirementfor the commencement of most Jewish religious services. Priestsare Catholic, Sangha are Buddhists and a Swami is a religiousteacher of Hinduism.
  22. 22. *http://www.mikvah.org*http://m.nursingtimes.net/205662.article*http://abcnews.go.com/Health/herpes-strikes-nyc-babies-ritual-circumcisions/story?id=18890284#.UaTe1ZS_Fsc.email