The cultural context of pregnancy may seem straightforward to medical practitioners and healthcare providers who have worked with standard hospital pregnancies for many years. However, if your institution begins to see more expectant mothers from other cultures, you’ll find that your standard practices may not meet the cultural expectations of these mothers and their families. It is important, therefore, to talk early and clearly about expectations for childbirth so that you can direct your patients to the right places and support structures that will help them through their pregnancy in a way that is safe and healthy for both mother and child.
Be Aware of Cultural Considerations Surrounding Pregnancy
Based upon generations of experience, women from every culture have a complex patchwork of methods for handling the pain and complications associated with childbirth. The expectant mother you meet may have received advice from her mother or grandmother that conflicts with your knowledge of evidence-based care. It is important to learn as soon as possible what the mother and family are expecting from the birth plan. The birth plan should be in both English and the mother’s native language. An interpreter should be utilized throughout the mother and family’s care and documents should be translated into their language of preference.
Knowing the advice given by the family and culture can help you to include cultural considerations into the birth plan. This is especially true of interventions that aren’t medical in nature; an example, for instance, may involve the gender of those present at the birth or the expectations that the father of the child will cut the cord. If possible, allow for cultural expectations to be met if they cause no undue hardship or medical danger; this creates comfort and trust between the family and tending medical staff.
Utilize the Interpreter as a Tool for Understanding
Talk with the interpreter to see if there are any cultural tips he or she can give you about helping an expectant mother to feel heard, valued, and empowered. Ask about folk beliefs to get a better understanding of a patient’s perspective. In Mexico, there is a belief that food cravings (antojos) a mother might have during her pregnancy can lead to certain characteristics in the child if not satisfied. For example, if a mother’s craving for strawberries is unmet, it is believed that the child will develop strawberry spots (strawberry hemangiomas) on their skin. Understanding this information will help the nutritionist plan an appropriate diet that accounts for culture, interpersonal belief, and nutritional value putting the family at ease. If a question seems to catch your patient off-guard, attempt to learn from the interpreter or the patient and ask how you can rephrase.
The Difference Between Interpreters and Doulas
Doulas and interpreters overlap many services during pregnancy, but it is important to recognize that they are distinctly different positions requiring distinctly different skill sets. Both are advocates for the expectant mother who have extensive knowledge and experience with pregnancy and the birthing process. Often, doulas assist women from their own cultural background but are familiar with the medical system in the United States, allowing them to be a bridge between an expectant mother and the medical professionals with whom she interacts. Doulas provide emotional and mental support for a mother during pregnancy. The interpreter is an impartial advocate whose sole purpose is to ensure clarity in communication between all parties.
Awareness of Offerings in the Community
It is possible that the desires of a patient, especially in regard to pregnancy, will be outside the bounds of the care you offer. You may, for instance, require certain interventions after a child is born in your medical facility. If your patient is completely uncomfortable with those interventions, you will want to work with them as early as possible to get the medical help they need in a context that will help them move forward with their care. This can often mean connecting to homebirth midwives or birthing centers in the area. Part of extending excellent care involves making sure women understand the options available to them, even if they are working with limited options through their medical insurance. Work with the interpreter to help your patient understand that she can find the right birthing professionals for her, even if that means not giving birth in your facility. It is better to establish her needs early on rather than having a traumatic, negative experience during her pregnancy and birth. An interpreter can help you ensure that, when your patient chooses to proceed with your practice, she understands what is coming next.
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