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Pregnancy and childbirth through a cultural lens


Tools to help educators increase their cultural competences.

" Cultural competence goes far beyond the Golden Rule – treat people as you would prefer to be treated. That works only when someone wants to be treated the same way as you."

Patricia Santiago-Munoz, M.D.

The Golden Rule

"Treat others as you wish to be treated"

When educators and healthcare providers understand their patients within the context of society, culture and the environment as a whole, they will be better able to communicate about physical and mental health, and ultimately improve health outcomes for mother and child.

Birth customs around the world

Latin America

La Cuarentena


  • 40 days of rest
  • No spicy foods
  • No sex
  • No physical activity


Bali

Burying the placenta


  • Placenta is alive
  • Cleaned, buried during ceremony

Japan

Ansei


  • Three weeks of recovery
  • Woman stays in parents' home
  • Family members help with chores

The Netherlands

Home birthing


  • Now only 20% are home births
  • Highest number in Western world
  • Birth is part of life, not an illness

Germany

Mutterpass


  • Booklet with baby's information
  • Helps keep doctors informed

United States

Institutional


  • Highly standardized
  • Home births are coming back
  • Baby blanket

Nigeria

Omugwo


  • Baby's first bath
  • Given by grandmother
  • Mother is not alone

Why is cultural awareness important?

Environment

or
genetics?

Although genetics and lifestyle play a critical role in shaping health outcomes for individuals, environmental conditions are equally as important.

By increasing cultural and social awareness, educators can play an important role in the physical and mental health of pregnant youth.

Environment

Where we are born, live, work and age are all social determinants of health. These play an important role in shaping our health outcomes.

Cultural and Social awareness

The social determinants of health are shaped by historical, social, political and economic forces. These help explain the relationship between environmental conditions and individual health.

Health

By recognizing the importance of the social determinants of health, educators can better understand patients, and communicate with them about health-related conditions, thus improving their health outcomes.

Things to consider

  • Family dynamics- don't make assumptions
  • Modesty - Let your students talk to you about their pregnancy, or child. Use common sense, don't touch their belly without asking.
  • Religious and cultural beliefs - everyone has different approaches to pregnancy and childcare.

What can educators do?

Acknowledge your personal biases

We all have prejudices, we are all biased. Acknowledge your personal biases to ensure that they don't affect the wellbeing of your students.

Refer students to local social services

Keep brochures and pamphlets for help with housing, food banks, therapy, support groups.

Watch out for stereotypes

Stereotyping patients based on cultural beliefs you may hold can negatively affect interactions with your students.

Source: https://journals.lww.com/nursingmadeincrediblyeasy/fulltext/2018/03000/a_nurse_educator_s_guide_to_cultural_competence.5.aspx

Bias self-assessment

  • What's my cultural identity?
  • How's it similar/different from my students'?
  • What assumptions do I have about other cultures?
  • Are minority students given equal opportunities to express themselves?
  • Do I respect, appreciate, and embrace diverse points of view?
  • What's my comfort level when I'm with students who have cultural characteristics that are different from mine?
  • Do I ask students from minority groups to be the class expert regarding that culture?
  • What are my assumptions regarding students' diverse characteristics, and do I challenge these personal biases and assumptions?
  • How do I respond to conflict and high-emotion situations?
  • Do I use culturally competent techniques to challenge intolerance (in and out of class)?
  • What are my teaching style preferences and what alternative methods do I use that help diverse students (for example, multimedia or psychomotor approaches)?

Class assessment

  • How students may perceive the learning environment and learning challenges
  • What students think and do related to their own learning goals based on their social and cultural networks
  • The type of education that students consider useful and appropriate
  • Each student's own cultural identity and cultural awareness
  • Each student's level of comfort with and commitment to the learning environment and the student-faculty roles within that environment.

  • Nursing Made Incredibly Easy!: March/April 2018 - Volume 16 - Issue 2 - p 19-23 doi: 10.1097/01.NME.0000529955.66161.1e
  • https://utswmed.org/medblog/cultural-competency-pregnancy/
  • https://www.huffpost.com/entry/world-birthing-traditions_n_7033790
  • https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/01/importance-of-social-determinants-of-health-and-cultural-awareness-in-the-delivery-of-reproductive-health-care?utm_source=redirect&utm_medium=web&utm_campaign=otn

References

Thank you!