2. Review the meaning of culture
Rationalize the discussion of culture as it
relates to pregnancy, childbirth and the
postpartum, including the newborn
Discuss some cultural beliefs and practices in
pregnancy, childbirth and the postpartum,
including the newborn
Provide culture-based midwifery care to
women, newborns and their families
LEARNING OUTCOMES
3. WHAT IS CULTURE?
Entire pattern of beliefs, attitudes, values,
ideas, norms, practices and knowledge that
different social groups hold about themselves
It is the social inheritance of individuals
4. WHAT IS THE RATIONALE FOR THIS
SESSION?
Childbearing women are cultural beings with
unique beliefs and practices that they will bring
to the Client/Midwife relationship. Some are
good, some are harmless and some are bad
Midwives are also cultural beings with beliefs and
practices that may influence the care they
provide
International Confederation of Midwives
competencies stipulate culture-based care
5. CULTURAL BELIEFS AND PRACTICES IN
PREGNANCY
Proven fertility is desirable in almost all
Malawian cultures
Non-disclosure of the existence of pregnancy
Dressing in loose clothes; Chitenje above
breast level
Counselling by older women
6. THE DOs AND DON’Ts (1)
Do rest – Mum or mother in-law comes to stay
especially towards end of pregnancy
Do eat ochre (thelele) to make the birth canal
slippery for the baby to pass easily
Do not eat spicy foods or baby will have a rash
Do not eat eggs or your baby will have an oval
head
Do not eat offal or the baby will have a cord
around the neck
7. DOs AND DON’Ts (2)
Do not have sex after the 6th month
otherwise the baby will be born with sperm all
over the body (this is vernix of course!!)
Do not stand in the doorway otherwise the
baby will be stuck in the pelvis
Do not prepare for the baby or it will be
stillborn
8. BELIEFS AND PRACTICES IN LABOUR
AND DELIVERY (1)
Home birth for the first baby to prove
paternity
Traditional oxytocin (Mwanamphepo) to
accelerate labour. Some cultures use Chisoso
Seeking uncle’s permission to go to the
hospital for delivery (Mwini mbumba)
Bearing a stone on the back to delay delivery
9. BELIEFS AND PRACTICES IN LABOUR
AND DELIVERY (2)
Vaginal birth against C/Section
Spouses not acting as birth companions
Linking obstructed labour and Eclampsia to
infidelity. Managed by untying knots and
taking Nsasi seeds orally
Cultural disposal of placenta
10. CULTURAL BELIEFS AND PRACTICES IN
THE PUERPERIUM (1)
The woman is considered “dirty”
She is confined to a room (Chikuta) for about
a month; no cooking especially meals needing
salt; she is expected to wear the same
maternity clothes
She is not expected to share a bed with her
spouse while in Chikuta
11. CULTURAL BELIEFS AND PRACTICES IN
THE PUERPERIUM (2)
She has to abstain from sex for a further
three months, even more in some cultures
Either cow dung, maize husks, wood sap or
breast milk is applied to the umbilicus
When the umbilical cord falls off it is disposed
of secretly
Baby not handled by “hot” people
12. CULTURAL BELIEFS AND PRACTICES IN
THE PUERPERIUM (3)
The baby is given a medicinal bath, usually at
the naming ceremony and the hair is shaved
Charms are tied to his/her neck, wrists and
waist for protection against evil spirits
The baby is given concoctions for strength
e.g. water used for hand-washing and Maoza
13. PROVISION OF CULTURE SENSITIVE
MIDWIFERY CARE
Use of the Midwifery management process
provides opportunities to identify the cultural
background of the client
ICM stipulates competencies that require a
Midwife to have knowledge of local culture
and traditional practices; the Midwife to
respect the individual woman’s culture,
customs including religion and provide
culturally acceptable care – NOTHING LESS!
14. REFERENCES
Kamwendo, L. A. (2010) Sexual and
Reproductive Health: What you have always
wanted to know, Montfort Media, Balaka,
Malawi
Selin, H. & Stone (2009) Childbirth Across
Cultures: Ideas and Practices of Pregnancy,
Childbirth and the Postpartum, Springer, London
15. McConville, B. (2014) On Becoming a Mother:
Welcoming Your New Baby & Your New Life
with Wisdom from Around the World, Oneworld
Publications, London
