Transcript Study on the Customs of South Indian Mothers during pregnancy AUTHOR Dr .A.

Study on the Customs of South
Indian Mothers during pregnancy
AUTHOR
Dr .A. K. AVASARALA
MBBS,M.D.
PROFESSOR &HEAD
DEPT OF COMMUNITY MEDICINE
& EPIDEMIOLOGY
PRATHIMA INSTITUTE OF
MEDICAL SCIENCES,
KARIMNAGAR,A.P..
INDIA : +91505417
[email protected]
Introduction
• Customs in a community will
play a key role in its health
promotion.
• Some of these customs
positively contribute to
increase the health of the
mother and the child while
some affect them adversely.
Introduction
• Most of the customs will have
a cultural background rather
than a scientific basis
• In this study, it is attempted to
bring out the various social
customs prevalent among the
south Indian mothers during
pregnancy
Learning objectives
• To know the various social
customs practiced by the
south Indian mothers during
pregnancy.
• To know the reasons behind
these social customs
Performance objectives
• To educate the women ,the
elders and dais (dais are old
women who will conduct
deliveries in villages) about the
positive and negative
influences of the social
customs
• and to change their attitudes.
Study population
• 50 urban women who attended
urban Maternal child health centre
,Chengalrao peta , Visakhapatnam)
• 50 women from antenatal clinic at
urban slum, kallupaakalu living in
urban slums
• 50 women in rural villages of rural
health centre ,Simhachalam
•
=Total 150 women
METHODOLOGY
• By survey using a pretested
questionnaire enquiring about
the----1. General customs
2. Dietary practices
3. Customs regarding rest,
personal hygiene& breast
feeding
•General
Customs
Seemantham
• In Indian culture, motherhood is
sacred and brings proud ness to
the woman and her parents
• This is exhibited in the form of
Seemantham .
• It is the celebration that the child
attained viability
Seemantham ( Bangle
ceremony)
• As soon as the fetus becomes viable by
7th month, the parents of the pregnant
woman proudly celebrate by inviting all
parous women around .
• Each of them will put a pair of bangles on
the hands of the pregnant woman and
blesses the pregnant woman to have safe
delivery and healthy child.
Place of delivery
• Usually women prefer parent’s home
for the first delivery .They will have fear
for first pregnancy and they feel
relaxed at their birth place ,hence the
preference.
• They prefer mother -in-law’s homes for
later deliveries. This may be with the
purpose of sharing the burden.
Travel preferences
• For the fear of abortion, mothers
prefer to travel only after 7th or 9th
month i.e. after the fetus attained
viability.
• After child birth , they return to
their husband’s house only after
3rd or 5th month. This may be due
to avoid early sexual contact.
Waist belt use
• Wearing the waist belt is very
common custom . The main
reason appears to avoid distended
pot belly development after
delivery.
• They claim that gas will
accumulate in abdomen after
delivery and causes protuberant
belly, if it is not tied with a towel .
Ear plugging
• A very common rural custom
of covering the ears with a soft
cloth or plugging the ears with
cotton wool to prevent entry of
air into ear.
• They think that they will get
fever and earaches if it is not
done.
WEARING SLIPPERS
• Rural women, not wearing
the slippers antenatally ,
also wear them when they
become pregnant to avoid
wet feet and thereby fever.
Eclipses
• All pregnant women stay
indoors during eclipses
for the fear of ultra violet
irradiation casing
congenital defects in the
children.
PREVALENCE OF GENERAL CUSTOMS
CUSTOMS
URBAN
MOTHERS
N=50
(%)
URBAN SLUM
MOTHERS
N=50
(%)
RURAL
MOTHERS
N=50
(%)
Seemantham
(Bangle wearing ceremony)
70
04
30
Preference of mother’s home for first
two pregnancies
90
90
70
Preference of mother-in-law’s home
for third pregnancy
90
90
90
Preference of 7th month
(Antenatally) and 5th month
postnatally for travel
90
70
80
Wearing of waist belt
60
82
96
Ear plugging
50
80
90
Wearing of slippers
92
85
80
100
100
100
Staying indoor during eclipse
REASONS FOR GENERAL CUSTOMS
CUSTOMS
REASONS
•Seemantham
• (Bangle wearing ceremony)
Traditional (90%)
•Preference of mother’s home for first
two pregnancies
Traditional (92%) Better care (75%)
•Preference of mother-in-law’s home
for third pregnancy
Traditional (75%) Sharing the burden
(25%)
•Preference of 7th month (Antenatally)
and 5th month postnatally for travel
Traditional (92%) Abortion risk passed
away (8%)
•Wearing of waist belt
To avoid pot belly(80%)
•Ear plugging
To prevent earache (70%)
•Wearing of slippers
To avoid wet feet and fever (92%)
Fear of congenital defects in the child.
•Staying indoor during eclipse
•Dietary
customs
Water consumption during
pregnancy
• All pregnant women consume less water
during and after pregnancy
• Antenatally they are afraid of water
logging of the body and postnatally they
wish to get dried up as soon as possible.
• Hence mother in laws or elders will allow
only hot water, not cold water, to drink as
it cannot be consumed much.
Food practices
• Antenatally, food quantity is reduced
by rural women for the fear of
obstructed labour by big baby
whereas with urban women this is
less practiced.
• Quantity is increased postnatally by all
women to get rid of weakness and to
increase milk secretion.
Food restrictions
• Fish is avoided by rural women for the fear
of causing pruritis.
• Papaya is universally forbidden thinking it
is an abortifacient.
• Greendal is restricted for fear of infections
in the child and the mother.
• Green leafy vegetables were restricted for
fear of loose motions in the child.
Special food items
• Kayam- a special food preparation which is
made up of jaggery, asafetida, cloves will be
eaten daily for 3 days postnatally by most of
the rural mothers to get the uterus involuted
quickly.
• Fried jeera( a spice) rice along with the food to
warm up the body postnatally will be taken by
rural mothers.
• Alcohol:-Few pregnant mothers will consume
alcohol for the same purpose
• All the postnatal women think ,if they don’t
keep their body warm ,they will go into shock.
PREVALENCE OF DIETARY CUSTOMS
URBAN
URBAN SLUM
RURAL
MOTHERS
MOTHERS
MOTHERS
CUSTOMS
N=50
(%)
N=50
(%)
N=50
(%)
Restricting Drinking water
80
90
90
•Hot water antenatally
•Hot water postnatally
30
80
37
90
60
94
•Less food-antenatally
•More food postnatally
30
30
70
80
40
70
24
92
24
50
24
70
96
64
76
72
74
100
90
84
64
22
5
30
30
78
60
02
Food restrictions:
•Fish
•Papaya
•Greendal
•Pumpkin
•Green leafy vegetables
Special food items:
•Kayam
•Fried Jera
•Alchol
REASONS FOR DIETARY CUSTOMS
CUSTOMS
REASONS
Restricting Drinking water
Fear of water logging of body(70%)
•Hot water antenatally
•Hot water postnatally
Cannot drink more (75%)
•Less food-antenatally
For fear of big baby and difficulty labor(16%) Indigestion (15%)
•More food postnatally
To get rid of weakness (54%) increased hunger (35%) to increase milk
secretion (12%)
Food restrictions:
•Fish
•Papaya
•Greendal
•Pumpkin
•Green leafy vegetables
Special food items:
•Kayam
•Fried Jera
•Alchol
•Pruritis (77%)
•Abortifacient (60%) elders advice(14%)
•Infection to mother & child (80%)
•Peripheral neuritis (82%)
•Diarrhoea in child (75%)
•To get dried up postnatally (68%)
•To keep body warm (60%)
•To prevent for shock (2%)
•Customs
regarding:•Rest&work
•Personal hygiene,
•Breast feeding
Rest &work
• Antenatally, rest will be taken
during pregnancy by all women,
more so in urban women.
• Postnatally, all women prefer to
take rest to ease their weakness
and regain their strength .
Personal hygiene
• Rural women will be given
th
head bath on 11 day as the
vaginal discharges stop by
that day.
• Till then, they will take sponge
bath only.
Breast feeding
• Colostrum is discarded mainly
by rural women due to their
illiteracy. They call it witch’s milk.
• Feeding is commenced on the
first day by half of the women
only.
• If feverish, feeding will be
stopped.
REST, HYGIENE& BREAST
FEEDING CUSTOMS
URBAN
MOTHERS
N=50
(%)
URBAN slum
MOTHERS
N=50
(%)
RURAL
MOTHERS
N=50
(%)
Rest:
•Antenatally
•Postnatally
76
80
70
57
60
62
Personal hygiene:
•Head both on 11th day
•Hot water bath
90
66
90
40
90
40
10
70
80
78
50
75
90
30
75
CUSTOMS
Breast feeding:
•Colostrums discarding
•Starting of breast feeding on 1st
day
•Privacy during breast feeding
REST, HYGINE& BREAST
FEEDING CUSTOMS
CUSTOMS
Rest:
•Antenatally
•Postnatally
Personal hygiene:
•Head both on 11th day
•Hot water bath
Breast feeding:
•Colostrum discarding
•Starting of breast feeding on 1st day
•Privacy during breast feeding
REASONS
•To get rid of weakness (47%)
•Elder’s advice (33%)
•As vaginal discharge stops(57%)
•To ease the body pains (34%)
•Elder’s advice (9%)
•Harmful to child (90% of rural mothers)
•indigestion to child (10%)
•indigestion to child (70% of rural mothers)
•Privacy to mother (75%)
•Infection to child (10%)
•Dhisty (Jealous & harmful looks of
neighbors) to child (15%)
Health role of the customs
• This is difficult to define .
• Most of the general customs appear to be
traditional in nature, intermingled with the
culture and carried out as conventions as per
the advice of the elders. .
• Seemantham appears to be having positive
psychological health influence as it causes
proud ness and self confidence in women
because motherhood gives perfection woman
hood in Indian culture.
Health role
• Going to parent’s home ,during
the first pregnancy , gives the
woman the opportunity to be
away from her husband and sex,
and to have rest, to learn mother
craft and of getting accustomed
to the place of delivery.
Health role
• Traveling after
th
completion of 7 month
of amenorrhea can be
approved as healthy as
risk for abortion lessens.
Health role.
• Eclipse fear and papaya as the
causes of fetal damage are so
deep rooted even the educated
women will not take risk.
• These are so strong , there is no
scope for even studying the
association.
Health role
• Colostrum discarding,
• taking less food antenatally,
• Taking harmful alcohol and Kayam
etc,
• avoiding nutritious dals , leafy
vegetables, fish in food , and water
antenatally
---are all unhealthy customs
Nutritional education
• Nutritive values of the various foods to
be explained to the women, elders, dais
to eliminate unnecessary restrictions.
•
They must think that pregnancy is
physiological and there is no need for
unnecessary restrictions of food
Dais’ training
• The rural women are practicing
these customs on the advice of
either their elders or the old
traditional dais who conduct
deliveries in the villages. .
• Hence it is important first to change
the attitude of these elders and dais
regarding the customs by giving
them proper training.
conclusions
• As most of the customs are
traditionally based, culture
oriented and sensitive , a careful
approach of health education of
all reproductive women is to be
planned for without hurting their
cultural feelings.