Group Culture Discussion (OB)

What interventions (epidural, labor induction, etc), does this cultural group routinely deny or accept during childbirth? (African Americans)

Belief in illnesses as natural (due to natural forces that the person hasn't protected self against) and unnatural (due to person or spirit). African American women enjoy their mothers and grandmothers to be present for the birth. The use of using an epidural when giving birth is 62.1%. African American women are more likely to deliver by C-Section.

What interventions (epidural, labor induction, etc), does this cultural group routinely deny or accept during childbirth? (Arabs)

Birth is usually considered strictly a "feminine experience" so they may deny male health care providers. The husband is typically not present in the room during the birth of their child. Female family members typically help with the delivery such as mother, sister, sister-in-law, or mother-in-laws. Modesty is important for Arabic women and will typically not want to deliver unclothed.

What is the view on breastfeeding? (African Americans)

Breastfeeding for African American mothers are lower than other racial groups, it is 16 % less than white mothers. African American mothers and their babies are at a higher risk for poor postnatal outcomes. Only 9.8% are exclusively breastfeeding at six months. Grandmothers support is key in successful breastfeeding for African Americans.

What are the beliefs and practices of the cultural group that affects pregnancy and childbirth health? (African Americans)

First, African American women are actively involved in seeking information about their pregnancies and childbirth. Second, they rely on family, especially female relatives, for information and support. Third, they may be less likely than Caucasians to attend childbirth classes. Finally, racism is an experience in the lives of pregnant African American women that may contribute to disparities in the birthing outcomes compared to Caucasian women.

Are there any religious practices that will be displayed during the pregnancy or childbirth for the group? (Asian)

Western culture discourages eating right before giving birth because they think a full stomach will cause vomiting during labor, especially active labor. The Asian women try to avoid "cold foods" such as bean sprouts, banana, and watermelon in the first trimester to avoid miscarriages. Women are also taught to avoid shelled seafood like crab and shrimp so that the baby does not develop rashes. They are most concerned with the balance of "yin and yang" which is also known as "hot and cold".

How does the culture view women? (African Americans)

Mother is considered the head of the household, and grandmother is most revered.

How does the culture view women? (Hispanics)

Mothers are the care taker. They're expected to be housewives. They are the decision makers for the health of everyone. Latina females are expected to manifest respect and even submission to their husbands. They are responsible for teaching the children culture and religion. 51% of Hispanic teenagers are going to become pregnant before 20 years old.

What is the view on breastfeeding? (Caucasian/Europeans)

One of the only countries that isn't encouraged and sometimes discouraged by handling of formula

What interventions (epidural, labor induction, etc), does this cultural group routinely deny or accept during childbirth? (Hispanics)

They are 53% less likely to have an epidural. They are 41% less likely to use a combination of epidural and IV meds. Hispanics have a belief that epidurals cause permanent back damage. They fear a c-section and prefer a vaginal birth.

What complimentary or alternative medicine does the cultural group likely participate? (Asian)

They believe in acupuncture, Tai chi, Qigong, and herbs. The Tai Chi is all about mind and body practices which are gentle, dance like body movements using mental focus and relaxation. The herbs are believed to be all natural and free of any adverse effects.

Are there any religious practices that will be displayed during the pregnancy or childbirth for the group? (Arab)

This tradition is a result of a passage in the Quran where Allah told the mother of the prophet Isa to eat dates so that the child would be patient and clever. There are also many references to breastfeeding in the Quran that encourage Muslim women to breastfeed their children for at least two years. All Muslim fathers are to recite an adhan in their infant's right ear so that it is the first words he or she hears. An adhan is a call to prayer

What complimentary or alternative medicine does the cultural group likely participate? (African Americans)

Use of folk healing and home remedies common to treat body, mind, and spirit. The most common examples of CAM are prayer, vitamins, exercise, meditation, herbs, chiropractic medicine, glucosamine, and music therapy.

What complimentary or alternative medicine does the cultural group likely participate? (Arab) Natural health products

are products other than Vitamins and Minerals that presented a health claim. This category includes natural products and mixes with claims of treatment of multiple health conditions including obesity, chronic diseases (such as diabetes, hypertension, high blood cholesterol, and triglycerides), and energy boosters.

How does the culture view women? (Caucasian/Europeans)

children & pregnancy viewed as a hardship/inconvenience Midwives/home births considered foolish and dangerous

What complimentary or alternative medicine does the cultural group likely participate? (Arabs) Vitamins and Minerals

consisted of single, multimineral, multivitamin, and multivitamins and mineral products.

What complimentary or alternative medicine does the cultural group likely participate? (Arab) Folk Foods

referred to functional foods that were included in the diet for their believed health benefits, like honey, black seed, molasses, artichoke, onion, garlic, and asparagus.

Are there any barriers to healthcare for women? Amish

7. Transportation makes it difficult to get to health care providers. High costs deter use of medical system because they do not carry private insurance. Language barriers also make it difficult to understand medical terminology.

What is the view on breastfeeding? (Native American)

-for it -"a way to nurse a baby's mind, body, and spirit"

Are there any barriers to health care for women? (Native American)

-for those who are not secluded, the access to healthcare might be promoted though Cherokee forgiveness programs -if the native American has lived off the service area for longer than 180 they will not be eligible for the free healthcare

What complimentary or alternative medicine does the cultural group likely participate? (Native American)

-herbal medicines and healing ceremonies

Are there any religious practices that will be displayed during the pregnancy or childbirth for the group? (Native American)

-rituals to protect and guide the baby. Lingering in doorways -men will not view birthing

What are the beliefs and practices of the cultural group that affects pregnancy and childbirth health? (Native American)

-they usually have a midwife help with delivery -women like to sit upright when delivering (squatting) -they prefer to use a sash belt while giving birth

What interventions (epidural, labor induction, etc.) does the cultural group routinely deny or accept during childbirth? (Native American)

-they will deny raccoon, pheasant, and black walnuts

What are the beliefs and practices of the cultural group that affects pregnancy and childbirth health? (Amish)

1. Amish do not believe in medication or in hospital medical care. They believe that they should have as many children as God decided to bless them with. So, most Amish families can have anywhere from 5-12+ children.

What complimentary or alternative medicine does the cultural group likely participate? (Amish)

2. Fold medicine: faith healing, herbal treatments. Meds help, God heals.

What interventions (epidural, labor induction, etc), does this cultural group routinely deny or accept during childbirth? (Amish)

3. No epidural. It is normal to birth completely naturally at home with husband and midwife present. Have a special dress to cover up most of their body during labor. No due dates or timed deliveries. Only time they induce or have a c-section is if there is a medical emergency.

What is the view on breastfeeding? (Amish)

4. Amish women breastfeed very privately. "When an Amish mother nurses her baby, she removes the straight pins from her dress, sticks them in her cape where they will not harm the baby, and separates the dress beneath her cape, exposing her breast to the baby. It is very discrete." They only time they do not breastfeed is if they are ill or no milk is produced. They do not believe the babies should feed immediately and usually hold off for several hours or the next day.

Are there any religious practices that will be displayed during the pregnancy or childbirth for the group? (Hispanics)

5. Enduing the pain of labor and being strong throughout the process is valued in this culture. The babies are given a red or pink bracelet to wear to protect them from the evil eye, Mal De Ojo. If the mom observes a lunar eclipse it will cause the baby to develop a cleft lip or pallet. If the mom craves a particular fruit during pregnancy, the baby will resemble it. They bury the placenta and umbilical cord in dirt to prevent bad luck.

Are there any religious practices that will be displayed during the pregnancy or childbirth for the group? (Amish)

5. No specific religious practices during pregnancy. Amish babies are not baptized until the age of 16 when the child is able to choose Amish way of life willingly.

How does the culture view women? (Amish)

6. Clean patriarchy where women are expected to marry, have children and submit to their husbands will. They cannot get a divorce and are expected to care for children. Tasks include cooking, sewing, cleaning, gardening, and maintaining the welfare of the family. Only 3% have jobs outside the home. Major decisions are made with both husband and wife.

Are there any barriers to healthcare for women? (Hispanics)

7. They hold off seeing the doctor unless they are seriously ill because of lack of insurance. Latina women are rarely offered health care benefits from their jobs. They prefer CAM therapy over traditional western medications. Many of them speak only Spanish which is a barrier for English speaking doctors.

What are the beliefs and practices of the cultural group that affects pregnancy and childbirth health? Additional European American beliefs (Caucasian/European)

A pregnant woman should not reach over her head because the baby may be born with the umbilical cord around its neck If you wear an opal ring during pregnancy, it will harm the baby. Birthmarks are caused by eating strawberries or seeing a snake and being frightened. Congenital anomalies can occur if the mother sees or experiences a tragedy during her pregnancy. Nursing mothers should eat a bland diet to avoid upsetting the baby. The infant should wear a band around the abdomen to prevent the umbilicus from protruding and becoming herniated. A coin, key, or other metal object should be put on the umbilicus to flatten it. Cutting a baby's hair before baptism can cause blindness. Moving heavy items can cause your "insides" to fall out. If the baby is physically or mentally abnormal, God is punishing the parents

Are there any barriers to healthcare for women? (African American)

African American women suffer maternal mortality ratios far higher than any other ethnic group. The risk of maternal mortality has remained about 3-4 times higher than white women. Higher mortality rates are suspected to be caused by low socioeconomic status, limited or no insurance coverage, bias among health care providers (which may foster distrust), and quality of care available in community.

What is the view on breastfeeding? (Asian)

Asian culture has the lowest breastfeeding rates in the world. It is shunned by asian culture.

What are the beliefs and practices of the cultural group that affects pregnancy and childbirth health? Pregnancy and Childbearing Practices (Caucasian/European)

Commonly used methods of birth control among Americans include natural ovulation methods, birth control pills, foams, Norplant, the morning-after-pill, intrauterine devices, sterilization, vasectomy, prophylactics, and abortion. Pregnant women should refrain from being around loud noises for prolonged periods of time. The father is often encouraged to take prenatal classes with the expectant mother and provide a supportive role in the delivery process.

What are the beliefs and practices of the cultural group that affects pregnancy and childbirth health? (Arab)

During and after pregnancy the women's mother, sister-in-law, sisters, and mother-in-law play a vital role in coaching and assisting the mother, especially the 40 days after birth. · "Arab Muslim women view pregnancy as a natural process, so seeking medical advice before pregnancy is perceived as unnecessary." · Women reported Lamaze and culture sensitive educational pregnancy classes would be very helpful in preparing for the pain of birth and different procedures. · Participants also concluded that these classes would be held with the pregnant women and another woman as it is unacceptable for a man to see another man with his wife.

How does the culture view women? (Native American)

Gender equality

Are there any religious practices that will be displayed during the pregnancy or childbirth for the group? (Caucasian/Europeans)

God parents are religious and cultural transitions practiced within European white cultures. Traditionally, all babies are wrapped in the exact same style blanket known as the "kuddle-up" blanket made by medline. Other traditions include preparing a nursery and having baby showers.

Are there any barriers to health care for women? (Asian)

Healthcare in asia allows women to progress past full term pregnancy, which increases the percentage of stillbirths. Asian women also tend to carry smaller babies, which increases the likelihood of infant loss.

What is the view on breastfeeding? (Hispanics)

Hispanic breastfeeding rates decrease with greater acculturation. They are more likely to introduce solid foods before 4 months of age. If the baby is taking from the nipple too suddenly, they believe the fontanel becomes sunken. They do not feed the baby colostrum because they believe it to be "dirty milk." Hispanic mothers are 33% more likely than other ethnic groups to provide formula supplementation as early as 2 days of life.

What is the view on breastfeeding? (Arab)

In the Arab culture, breastfeeding is encouraged according to the Qur'an which states: "Mothers shall breastfeed their children for two whole years, for those who wish to complete the term" (Huda, 2017). In 2014, breastfeeding was made mandatory when the United Arab Emirate passed a law requiring mothers to breastfeed the child under the Child's Rights Law (Salem, 2014). This law is applicable to able mothers and refers to breastfeeding as a duty and not an option. Concerning public breastfeeding, modesty is valued in the Arab culture; therefore, women often cover up as much as they can while breastfeeding, or do so in private or designated areas within facilities ("Breastfeeding in Dubai," 2017). There is not a general stigmatism against breastfeeding in public, however, individual opinions may differ.

How does the culture view women? (Asian)

In the asian culture, pregnancy is expected for married women. Women are expected to make raising their children a priority. They are also expected to stay home and do household work along with tending to their husbands needs.

What are the beliefs and practices of the cultural group that affects pregnancy and childbirth health? (Asian)

In this culture food, illness, and medications are classified as hot and cold. Pregnancy and especially childbirth are believed to disturb the balance of hot and cold required for good health. They eat special soups, chicken, and chicken broth. They do not eat lamb because of the belief that it may cause the baby to have epilepsy. They also do not eat pineapple because it is believed to cause miscarriage. They also believe that a woman should not cry out or scream during labor. The women prefer to sit or squat while giving birth and the mother or mother-in-law attends the birth rather than the father.

What are the beliefs and practices of the cultural group that affects pregnancy and childbirth health? (Hispanic)

Pregnancy is desired as soon as they get married. Expectant mothers are influenced strongly by her mother and mother in law. Unsatisfied food cravings are thought to cause a birth mark. Milk is avoided because it causes large babies and difficult births. It may be unacceptable to have a pelvic exam by a male. They may prefer the presence of their mother rather than husband. Male infants are not circumcised. Female infants ears are pierced. They have a 40 day period of no sex. The mother cannot shower for several days or get out of bed for several hours after birth.

Are there any religious practices that will be displayed during the pregnancy or childbirth for the group? (African Americans)

Religious and spiritual experiences are especially important during and after pregnancy because many religious traditions attach spiritual significance to childbirth, parenthood, and family. In addition, religious rituals (e.g., baptism, brit milah) and decision-making about religious upbringing of children often accompany this important life period. A brit milah is a religious Jewish male circumcision ceremony performed by a mohel, a circumcised', on the eighth day of a male infant's life.

What interventions (epidural, labor induction, etc.) does the cultural group routinely deny or accept during childbirth? (Asian)

Shorter pregnancies (39 wks) so induction is not recommended. Some will consider childbirth without an epidural but it is acceptable to get one. C-section is preferred because asian women have smaller pelvises.

Are there any barriers to healthcare for women? (Caucasian/Europeans)

Socioeconomic Class: Health insurance coverage; Geographic living area: Women who live in rural areas/regions are limited on health care facilities vs. those who live near hospitals have a very different experience.

Complimentary & Alternative Medicine (Caucasian/Europeans)

Spirituality Religion Vitamins/Supplements Chiropractic therapy Mind/Body yoga Manual therapy Massage therapy Homeopathy Acupuncture

Interventions deny/accept during childbirth (Caucasian/Europeans)

The norm is to do more interventions than not Very common for epidurals and induction Interventions are commonly accepted

How does the culture view women? (Arab)

The role of the women in Arabian culture is to bear and raise children. -Most of the women's power is mainly in the household expenditures, and the upbringing and education of the children. This is where woman's voice is heard the most. -Do not shake hands with an Arab woman unless she offers her hand first, or if you are a woman. -Do not flirt, touch, hug or talk in private with a woman. It could endanger their safety. -Men must stand when women enter a room. -Respect the different living "areas" for men and women. Do not expect women to eat or socialize in the same as men. -Women are expected to dress in full length body cover dresses and veils. Concerns of modesty are the reason for the dress. -The most devoted women cover their faces as well with veils. -In some local cultural traditions women are denied the right to an education. -Only about 25% of women in Arabian culture are in the workforce.

What complimentary or alternative medicine does the cultural group likely participate? (Hispanic)

The use of herbs treats complaints of pregnancy. Drinking chamomile tea is thought to ensure effective labor. After the first two days only boiled milk and toasted tortillas permitted. An old Hispanic tradition to induce labor is to brew cumin and potato tea. After the babies umbilical cord falls off, they believe you can put a coin or button over the belly button to prevent having an outtie belly button.

Are there any barriers to health care for women? (Arab)

There are several barriers to health care for Arab women. In their culture, it is recommended that women are modest and respect their husbands (Kronfol, 2012). This means that some women fear voicing their opinion when it comes to their own medical care (Kronfol, 2012). Also, there is a possible geographic barrier. Not all regions have health care facilities (Kronfol, 2012). This can create a language barrier depending on the geographic location where the women go to seek care. Just as in other cultures, cost and poor health literacy are barriers women face (Kronfol, 2012). Health care is expensive and not everyone can afford it. Poor health literacy affects these women in the fact that they may not know what options they have or where to go to receive the best care.

What complimentary or alternative medicine does the cultural group likely participate? (Arab) Folk Herbs

included all infusions made with traditional herbs and herbal extracts which were used to treat and/or prevent a health condition. Examples of such infusions were green tea, Anise tea, Thyme tea, and a mixture of specific flowers believed to prevent or treat common cold symptoms locally referred to as "Zhourat."