The title of “Mother” is a universal label suggesting that women who identify as mothers share the same personalities, characteristics, and preferences. Yet when we think about mothers, it is important to remember that each mother is an individual. How each woman approaches and embraces motherhood is largely informed by her familial and cultural lineage. Historical mothering practices are passed down through generations and shape her cultural narrative. These familial stories inform how she views her pregnancy, childbirth, and how she wishes to be cared for during the postpartum period.
Postpartum mood concerns are the number one complication of childbirth affecting between 15-17% of mothers. We know that perinatal mood concerns impact women of all cultural, educational, and socioeconomic backgrounds. Several variables, such as hormonal changes, sleep deprivation, social support, and one’s own personal and family mental health history can impact a woman’s risk of developing a postpartum mood concern, such as depression or anxiety.
As health care practitioners, when we care for racially diverse women, there are several unique cultural variables that may affect a woman’s emotional well-being after her baby is born. These cultural variables are especially important to tune into, because as health care professionals we serve at the forefront of maternal care. When a mother suffers from a perinatal mood concern, it’s often obstetricians, pediatricians and midwives that are the first to notice something is awry. Educating oneself about common cultural beliefs and patterns helps build and maintain trust with new mothers and their families. This trust helps ensure that providers have the repertoire that is necessary to recommend additional psychological support when it is needed most.
There are unique nuances and a diverse array of birthing rituals and practices; here are a few examples that are common within Asian cultures:
Gender of the baby: For some families, the root of male preference is deeply imbedded in cultural beliefs. The belief is that a male child will extend the bloodline, and that sons will care for their aging parents. In certain cultures, having a female child adds pressure financially and emotionally, because it is believed that the daughter will marry and contribute to another family. Depending upon familial cultural beliefs and practices, a woman may feel a range of emotions if she is not having the son her family desires. It’s important to note that in some Asian cultures, gender of the child may be correlated with perinatal depression.
Hot-Cold Beliefs: In certain Asian cultures, it is believed that a new mother should be in a state of “hot and cold” balance during the postpartum period. If a woman is too cold it is believed that this may slow down lactation and interfere with maternal bonding. Hot and cold practices are represented not only in temperature but also in how certain foods increase or reduce heat in our bodies. In the Western cold, women are often offered cold beverages during labor and following childbirth. However, these offerings may not be aligned with the cultural need to maintain the balance of warmth. Health care professionals can sensitively attune to these beliefs by asking women to specify their preferences for hot/cold beverages/food in their hospital birth plans. Adding these small details helps build and maintain trust during the very sensitive postpartum period.
Maternal Confinement: The belief system behind keeping a mom “confined” for up to 40 days is to aid in the recovery of childbirth. This is an opportunity for maternal bonding and for family members to provide support and security for the mothers as way to alleviate outside stress. Mehndi (also known as henna, aids in cooling, and is an herb that is applied on the hands and feet in an intricate design) helps remind the mother that she should rest until the design fades. The importance of the maternal bond is reflected in this practice. Here, the mother devotes her attention to the bond with her baby without the outside distractions and other demands in life. It’s important to note that in the Western world following childbirth, the focus shifts towards the baby. However, in many Asian cultures, the mother remains a focal point after her baby’s arrival. These practices may impact how quickly a new mother ventures out into the world and which recommendations she’s apt to find supportive during the new days and weeks of motherhood.
As healthcare providers, the more we educate ourselves about various cultural practices and the meaning of these practices, the more we can advocate for our diverse patient populations. As providers, we become strong advocates when we ask sensitive questions related to our patient’s cultural beliefs and how these beliefs impact motherhood. Supporting a woman in a way that culturally aligns with her view of motherhood can be a universal practice.
Dr. Bindu Garapaty is a leader in the Maternal Child Health arena. She is also the co-founder of The Happy Leader, a firm focused on executive leadership development. You can connect with her on Twitter @BinduGarapaty
Dr. Juli Fraga is a perinatal psychologist in San Francisco. She also co-developed and co-faciliates a postpartum depression support group, “The Afterglow” for the UCSF hospital. You can connect with her on Twitter @dr_fraga