The concept of childbirth is universal, which is known to link physical, psychological, spiritual, and cultural components. Although women give birth the same way, cultures globally distinguish some women from others due to different practices, preferences, and beliefs, which include the choice of the caregiver as an obstetrician, traditional birth attendants, midwives, or family physicians (Trotman Et al., 2015). Others differ in terms of birth positions, which could be either upright or lithotomy, and preferences of the gender to help in the childbirth process. The differences have been a major cause of inequalities of safety during delivery. Culture is a major determinant of the differences, and it impacts greatly on the choices that mothers make concerning delivery. As a result, due to culture, a mother would still deliver without an intervention despite improved healthcare services in healthcare institutions. The following paper reviews the customs and practices involved during and after childbirth in the Kilimanjaro area, Tanzania.
In the article “Customs and practices during pregnancy, childbirth, and the postpartum period in the Kilimanjaro area, Tanzania,” the author focuses on how people compromise between the traditional and the modern alternatives of maternity care. The article used interviews with nine women with children below five years and who lived in the village of Rombo in Kilimanjaro, using the local language and later translated into English. The article was focused on the inequalities that existed in the rates of safe delivery due to different cultures and customary practices (Ohnishi, Oishi, & Leshabari, 2015). Through various studies, the authors had realized the need to consider the cultural and socioeconomic factors that surround a people if their health was to be improved as well as their satisfaction in their childbirth experiences. In Tanzania’s research, it was identified that the country is undeveloped, with a huge population living in rural areas. It has poor infrastructure, making it hard for mothers to access better health care services during childbirth if need be.
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The women in the village demonstrated a higher understanding of the necessity of the health services, and they would prefer to deliver at a health facility instead of delivering at home using the traditional birth attendants. The increased knowledge is due to improved maternal care services. However, despite the knowledge, most women would still give birth at their homes, as forced by sociocultural factors that stood as barriers to accessing healthcare services. Some of the sociocultural factors include family and the community and their impact on the individual (Ohnishi, Oishi, & Leshabari, 2015). For instance, it was found that the mother-in-law, the girl’s mother, and the partner had a huge contribution to the choice of delivery form that the mother would have. Nevertheless, the mother-in-law had the greatest role in deciding whether a health facility would be accessed or not, and the mother had little or no choice to refrain from the given option.
Despite the recognition that healthcare institutions are a safe place to deliver, the community still considers the mothers who give birth at their homes as healthier than those who deliver in the healthcare centers. This becomes a motivating factor of mothers intending to deliver at their homes instead of the hospitals. Giving birth is considered a private event, and many women in the community, despite knowing the importance of the health facilities, claim that hospitals are not private, hence opting to deliver at their homes with the help of the TBAs. Additionally, hospital delivery means that the traditional celebrations are not held, and since it is a cultural norm, many mothers prefer giving birth at their homes to ensure they do not skip a cultural norm. Some of the celebrations include killing a goat and performing an exorcism. Finally, other women claimed that although the health facility maternal care services are quality, they did not seek quality, but rather to remain in line with their cultural norms, hence they would not go to a health facility.
When it came to postnatal care, mothers are allowed to breastfeed, while those who do not breastfeed are considered HIV positive. In other circumstances, they are considered to abandon their role as a mother, making it hard for the HIV positive mother, for they are considered to abandon their roles. Mothers are allowed to stay with their mother-in-law for the first six months to avoid another pregnancy, which would affect the growth of the breastfeeding baby (Ohnishi, Oishi, & Leshabari, 2015). Babies are breastfed exclusively until the third month when they are fed grilled mashed bananas with cow’s milk or butter prepared using the cow’s milk. Some foods such as offal are prohibited from the breastfeeding mother in the belief that they will affect the baby. However, lactating mothers and pregnant mothers are encouraged to eat the traditional and staple food such as bananas and goats. Traditional medicine is also used often during pregnancy and also during childbirth.
The community is bound to pressure women to conceive more children, and the women who bear boys are considered more, making those who only bear girls feel ashamed. For the women who cannot conceive, they are sent back to their parents. The women cited to prefer their freedom, but since their society is male-dominated, that would only live to be a wish. For instance, women who failed to get married by the age of 30 or do not have children are looked down upon even by their family members, making it hard for them to live in such a society.
It is, however, worth noting that the younger generation and one that is more educated prefer to give birth at the facilities (Ohnishi, Oishi, & Leshabari, 2015). They are also not strict to the traditional ceremonies. As a result, they are considered distant from their parents and families for defying cultural norms.
In conclusion, it is clear that sociocultural factors have a huge role to play in different cultures in determining the quality and type of maternal service that the mother would receive. In a society that seriously upholds its cultural norms, it may be hard to use the improved maternal care services at the health facilities for fear of abandoning the cultural norms and probably being rejected by the community. As a result, there would be a gap between the quality of safe delivery among mothers depending on the improved maternal care uptake and the use of traditional means of giving birth. However, governments have been trying to lure such people into the hospitals by using skilled traditional birth attends, who make the women from the community feel satisfied.
References
Ohnishi, M., Oishi, K., & Leshabari, S. (2015). Customs and practices during pregnancy, childbirth, and the postpartum period in the Kilimanjaro area, Tanzania. 保健学研究 , 27 , 85-90.
Trotman, G., Chhatre, G., Darolia, R., Tefera, E., Damle, L., & Gomez-Lobo, V. (2015). The effect of centering pregnancy versus traditional prenatal care models on improved adolescent health behaviors in the perinatal period. Journal of pediatric and adolescent gynecology , 28 (5), 395-401.
