Abstract

Thai women participate in various practices and precautions throughout pregnancy. Culturally competent care by the nurse is crucial during this time in a woman’s life. Thai women participate in both dietary and behavioral rituals throughout this period. Some dietary precautions include only eating certain foods like polished rice, and removing foods from their diets, like eggs. Behavioral practices of the woman are influenced by Traditional Thai medicine and include rituals like laying by a fire after the birth of the child, and not being able to complain or get upset during pregnancy or else bad things will occur. The purpose of this paper is to contribute an understanding of traditional beliefs and practices regarding pregnancy and childbirth among Thai women.This paper will also include the responsibility of the nurse and how culturally competent health care can be accurately conducted during this time. The nurse must identify their own personal beliefs before they can begin to accept the beliefs of a client’s. 

Keywords:  Thailand, pregnancy, culture, nursing

Thai Cultural Practices During Pregnancy

 Cultural and religious beliefs of the Thai women contribute to their reproductive value and to their pregnancy planning. Many beliefs and practices relating to the Thai childbearing process must be observed by the woman and her family to ensure the health and well-being of herself and her newborn baby (MacCormack, 1982). The experience of birth is a socially constructed event and is shaped by the beliefs of the culture that it occurs within. There are many factors that can interrupt the health of the mother and the baby according to their beliefs. Thai cultural practices play a crucial role during the antenatal (before birth), intrapartum (during labor) and postpartum (after birth) periods in pregnant women. It is the responsibility of the nurse to ensure that cultural practices are followed in a safe way. Caregivers are expected to be aware of their own cultural identifications in order to control their personal biases that interfere with the therapeutic relationship. Self-awareness involves not only examining one’s culture but also examining perceptions and assumptions about the client’s culture (Ferwerda, 2016). Patient education allows for a decrease in risks for the mother and baby. 

Practices during Antenatal period

Thai women partake in certain dietary precautions during this phase of pregnancy. Their culture prohibits eating certain foods like eggs because it can impact the fetus. In an interview conducted by Nigenda, Langer, Kuchaisi, Romero, & Rojas (2003), one woman said: “I don’t eat eggs as I’m afraid the baby will have a bad smell”. It is important for the nurse to be aware of these concerns of the patient and also accept these beliefs. The nurse may be helpful by helping the patient pick out meals that don’t contain any eggs. Thai women become more dependent on their spouses and mothers for emotional support. Thai women view pregnancy as a special time in their lives when they need extra care, both physically and emotionally. They acknowledge that this is a time when their moods can be unstable (Purnell, 2014). The nurse can involve the mother and husband in any prenatal teachings, which may help the new mom in feeling supported. Allowing the new mom to express her emotions throughout the pregnancy can help the family grasp a better understanding of what she is feeling. Pregnant women are advised not to complain or get upset so that the newborn will be happy and stay happy for the rest of their lives (Purnell, 2014). The nurse can teach the mother relaxation techniques such as meditation and deep breathing exercises. These techniques can be used if the mother feels herself getting upset at any time. Cultural beliefs play a big part in the life of a pregnant Thai woman.

Practices during intrapartum and postpartum period

Traditional intrapartum practices involve strict modesty rules.Owing to modesty, especially during a vaginal examination, Thai women prefer female health care providers (Purnell, 2014). It would be helpful if the nurse keeps the patient covered, if at any point there are not any female providers available; a male provider may need to step in. During the time of delivery, it is common for the woman to give birth with no family members present in the room. One study performed by Yuenyong, O’Brien, & Jirapeet (2012) has shown, the integration of a close female relative into the care of laboring and birthing women is an important nurse-midwifery intervention that can create a positive effect that elevates maternal self-confidence and self-control during labor and birth. The nurse can offer this intervention but must accept the patient’s choice if she declines. Based on traditional Thai medicine, caregivers use food, fire, water and herbs to rebalance postpartum women’s self, including body, mind-heart and energy.  One tradition in particular used to rebalance the postpartum woman is “yuu fai”, which essentially allows the woman to lay by a fire after she has given birth (Elter, Kennedy, Chesla, & Yimyam, 2014). This practice is not able to occur in the American hospitals, short hospitalizations are not even enough to fully address physical recovery. Therefore, other interventions are used in its place, for example giving the client hot tea, offering a warm sitz baths or a warm heating pad can be provided. These interventions create the heat effect that restores balance. There are also certain dietary practices that take place after the delivery of the child. One of the allowed foods for postpartum women is sticky, polished rice, which also has low potassium content (Kaewsarn, Moyle, & Creedy, 2003). Much of its vitamin content, such as thiamine, is destroyed from a long cooking process. The nurse may encourage the client to eat foods that have more thiamine. Understanding the cultural beliefs and nutritional practices during the postpartum period is important to assist providers in the provision of culturally appropriate and effective care and counseling.

Conclusion

 Traditional Thai culture and beliefs are embedded heavily in the day to day life of a pregnant Thai woman. Dietary and behavioral practices are performed in order to have a safe delivery and to keep the woman’s body healthy.  Early identification of culture related health behaviors may offer a unique opportunity for nurses to provide effective teaching and counseling to assist the new parents to engage in more optimal behaviors. It is essential for the nurse to be in direct collaboration with other members of the health care team to coordinate patient care (Brown et al., 2009). When everyone is in consistent communication, the needs of the patient can be established. This is especially important when dealing with clients from different cultures.

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