Study on the Customs of South Indian Mothers during pregnancy AUTHOR Dr.A. K. AVASARALA MBBS,M.D. PROFESSOR &HEAD DEPT OF COMMUNITY MEDICINE & EPIDEMIOLOGY.

Study on the Customs of South Indian Mothers during pregnancy

AUTHOR

Dr .A. K. AVASARALA MBBS,M.D.PROFESSOR &HEADDEPT OF COMMUNITY MEDICINE & EPIDEMIOLOGYPRATHIMA INSTITUTE OF MEDICAL SCIENCES, KARIMNAGAR,A.P..INDIA : [email protected]

Introduction• Customs in a community will

play a key role in its health promotion.

• Some of these customs positively contribute to increase the health of the mother and the child while some affect them adversely.

Introduction• Most of the customs will have

a cultural background rather than a scientific basis

• In this study, it is attempted to bring out the various social customs prevalent among the south Indian mothers during pregnancy

Learning objectives• To know the various social

customs practiced by the south Indian mothers during pregnancy.

• To know the reasons behind these social customs

Performance objectives

• To educate the women ,the elders and dais (dais are old women who will conduct deliveries in villages) about the positive and negative influences of the social customs

• and to change their attitudes.

Study population• 50 urban women who attended urban

Maternal child health centre ,Chengalrao peta , Visakhapatnam)

• 50 women from antenatal clinic at urban slum, kallupaakalu living in urban slums

• 50 women in rural villages of rural health centre ,Simhachalam

• =Total 150 women

METHODOLOGY• By survey using a pretested

questionnaire enquiring about the-----

1. General customs2. Dietary practices3. Customs regarding rest,

personal hygiene& breast feeding

•General Customs

Seemantham

• In Indian culture, motherhood is sacred and brings proud ness to the woman and her parents

• This is exhibited in the form of Seemantham .

• It is the celebration that the child attained viability

Seemantham ( Bangle ceremony)

• As soon as the fetus becomes viable by 7th month, the parents of the pregnant woman proudly celebrate by inviting all parous women around .

• Each of them will put a pair of bangles on the hands of the pregnant woman and blesses the pregnant woman to have safe delivery and healthy child.

Place of delivery• Usually women prefer parent’s home

for the first delivery .They will have fear for first pregnancy and they feel relaxed at their birth place ,hence the preference.

• They prefer mother -in-law’s homes for later deliveries. This may be with the purpose of sharing the burden.

Travel preferences• For the fear of abortion, mothers

prefer to travel only after 7th or 9th month i.e. after the fetus attained viability.

• After child birth , they return to their husband’s house only after 3rd or 5th month. This may be due to avoid early sexual contact.

Waist belt use• Wearing the waist belt is very

common custom . The main reason appears to avoid distended pot belly development after delivery.

• They claim that gas will accumulate in abdomen after delivery and causes protuberant belly, if it is not tied with a towel .

Ear plugging

• A very common rural custom of covering the ears with a soft cloth or plugging the ears with cotton wool to prevent entry of air into ear.

• They think that they will get fever and earaches if it is not done.

WEARING SLIPPERS

• Rural women, not wearing the slippers antenatally , also wear them when they become pregnant to avoid wet feet and thereby fever.

Eclipses• All pregnant women stay

indoors during eclipses for the fear of ultra violet irradiation casing congenital defects in the children.

PREVALENCE OF GENERAL CUSTOMS CUSTOMS URBAN

MOTHERS

N=50

(%)

URBAN SLUM

MOTHERS

N=50

(%)

RURAL

MOTHERS

N=50

(%)

Seemantham

(Bangle wearing ceremony)

70 04 30

Preference of mother’s home for first two pregnancies

90 90 70

Preference of mother-in-law’s home for third pregnancy

90 90 90

Preference of 7th month (Antenatally) and 5th month postnatally for travel

90 70 80

Wearing of waist belt 60 82 96

Ear plugging 50 80 90

Wearing of slippers

Staying indoor during eclipse

92

100

85

100

80

100

REASONS FOR GENERAL CUSTOMSCUSTOMS REASONS

•Seemantham• (Bangle wearing ceremony)

Traditional (90%)

•Preference of mother’s home for first two pregnancies

Traditional (92%) Better care (75%)

•Preference of mother-in-law’s home for third pregnancy

Traditional (75%) Sharing the burden (25%)

•Preference of 7th month (Antenatally) and 5th month postnatally for travel

Traditional (92%) Abortion risk passed away (8%)

•Wearing of waist belt To avoid pot belly(80%)

•Ear plugging To prevent earache (70%)

•Wearing of slippers•Staying indoor during eclipse

To avoid wet feet and fever (92%)

Fear of congenital defects in the child.

•Dietary customs

Water consumption during pregnancy

• All pregnant women consume less water during and after pregnancy

• Antenatally they are afraid of water logging of the body and postnatally they wish to get dried up as soon as possible.

• Hence mother in laws or elders will allow only hot water, not cold water, to drink as it cannot be consumed much.

Food practices• Antenatally, food quantity is reduced

by rural women for the fear of obstructed labour by big baby whereas with urban women this is less practiced.

• Quantity is increased postnatally by all women to get rid of weakness and to increase milk secretion.

Food restrictions• Fish is avoided by rural women for the fear

of causing pruritis.

• Papaya is universally forbidden thinking it is an abortifacient.

• Greendal is restricted for fear of infections in the child and the mother.

• Green leafy vegetables were restricted for fear of loose motions in the child.

Special food items• Kayam- a special food preparation which is

made up of jaggery, asafetida, cloves will be eaten daily for 3 days postnatally by most of the rural mothers to get the uterus involuted quickly.

• Fried jeera( a spice) rice along with the food to warm up the body postnatally will be taken by rural mothers.

• Alcohol:-Few pregnant mothers will consume alcohol for the same purpose

• All the postnatal women think ,if they don’t keep their body warm ,they will go into shock.

PREVALENCE OF DIETARY CUSTOMS CUSTOMS URBAN

MOTHERS

N=50

(%)

URBAN SLUM MOTHERS

N=50

(%)

RURAL MOTHERS

N=50

(%)

Restricting Drinking water 80 90 90

•Hot water antenatally•Hot water postnatally

30

80

37

90

60

94

•Less food-antenatally•More food postnatally

30

80

30

40

70

70

Food restrictions:•Fish•Papaya•Greendal•Pumpkin•Green leafy vegetables

24

92

24

50

24

70

96

64

76

72

74

100

90

84

64

Special food items:•Kayam•Fried Jera•Alchol

22

5

30

30

78

60

02

REASONS FOR DIETARY CUSTOMS CUSTOMS REASONS

Restricting Drinking water Fear of water logging of body(70%)

•Hot water antenatally•Hot water postnatally

Cannot drink more (75%)

•Less food-antenatally

•More food postnatally

For fear of big baby and difficulty labor(16%) Indigestion (15%)

To get rid of weakness (54%) increased hunger (35%) to increase milk secretion (12%)

Food restrictions:•Fish•Papaya•Greendal•Pumpkin•Green leafy vegetables

•Pruritis (77%)•Abortifacient (60%) elders advice(14%)•Infection to mother & child (80%)•Peripheral neuritis (82%)

•Diarrhoea in child (75%) Special food items:•Kayam•Fried Jera•Alchol

•To get dried up postnatally (68%)•To keep body warm (60%)•To prevent for shock (2%)

•Customs regarding:-

•Rest&work

•Personal hygiene,

•Breast feeding

Rest &work• Antenatally, rest will be taken

during pregnancy by all women, more so in urban women.

• Postnatally, all women prefer to take rest to ease their weakness and regain their strength .

Personal hygiene• Rural women will be given

head bath on 11th day as the vaginal discharges stop by that day.

• Till then, they will take sponge bath only.

Breast feeding• Colostrum is discarded mainly

by rural women due to their illiteracy. They call it witch’s milk.

• Feeding is commenced on the first day by half of the women only.

• If feverish, feeding will be stopped.

REST, HYGIENE& BREAST FEEDING CUSTOMS

CUSTOMS URBAN MOTHERS

N=50

(%)

URBAN slum MOTHERS

N=50

(%)

RURAL MOTHERS

N=50

(%)

Rest:•Antenatally•Postnatally

76

80

70

57

60

62

Personal hygiene:•Head both on 11th day•Hot water bath

90

66

90

40

90

40

Breast feeding:•Colostrums discarding•Starting of breast feeding on 1st day•Privacy during breast feeding

10

70

80

78

50

75

90

30

75

REST, HYGINE& BREAST FEEDING CUSTOMS

CUSTOMS REASONSRest:•Antenatally•Postnatally

•To get rid of weakness (47%)•Elder’s advice (33%)

Personal hygiene:•Head both on 11th day•Hot water bath

•As vaginal discharge stops(57%)•To ease the body pains (34%)•Elder’s advice (9%)

Breast feeding:•Colostrum discarding•Starting of breast feeding on 1st day•Privacy during breast feeding

•Harmful to child (90% of rural mothers)•indigestion to child (10%)•indigestion to child (70% of rural mothers)•Privacy to mother (75%)•Infection to child (10%)•Dhisty (Jealous & harmful looks of neighbors) to child (15%)

Health role of the customs • This is difficult to define .

• Most of the general customs appear to be traditional in nature, intermingled with the culture and carried out as conventions as per the advice of the elders. .

• Seemantham appears to be having positive psychological health influence as it causes proud ness and self confidence in women because motherhood gives perfection woman hood in Indian culture.

Health role• Going to parent’s home ,during

the first pregnancy , gives the woman the opportunity to be away from her husband and sex, and to have rest, to learn mother craft and of getting accustomed to the place of delivery.

Health role• Traveling after completion of 7th month of amenorrhea can be approved as healthy as risk for abortion lessens.

Health role.• Eclipse fear and papaya as the

causes of fetal damage are so deep rooted even the educated women will not take risk.

• These are so strong , there is no scope for even studying the association.

Health role• Colostrum discarding,

• taking less food antenatally,

• Taking harmful alcohol and Kayam etc,

• avoiding nutritious dals , leafy vegetables, fish in food , and water antenatally

---are all unhealthy customs

Nutritional education• Nutritive values of the various foods to

be explained to the women, elders, dais to eliminate unnecessary restrictions.

• They must think that pregnancy is physiological and there is no need for unnecessary restrictions of food

Dais’ training

• The rural women are practicing these customs on the advice of either their elders or the old traditional dais who conduct deliveries in the villages. .

• Hence it is important first to change the attitude of these elders and dais regarding the customs by giving them proper training.

conclusions• As most of the customs are

traditionally based, culture oriented and sensitive , a careful approach of health education of all reproductive women is to be planned for without hurting their cultural feelings.