The Meaning of Giving Birth: Voices of Hmong Women Living in Vietnam.

Increasing knowledge about the sociocultural context of birth is essential to promote culturally sensitive nursing care. This qualitative study provides an ethnographic view of the perspectives on birthing of Hmong mothers living in the highlands of Vietnam. Unique cultural beliefs exist in Hmong culture about the spiritual and physical world as well as ritual practices associated with childbearing. This includes variations of ancestor worship, reincarnation, and healing practices by shamans. Traditionally, Hmong families take an active role in childbirth with birth frequently occurring in the home. Situated within a large collaborative anthropology project, a convenience sample of 8 Hmong women, who had recently given birth, were interviewed regarding the perinatal experience. In addition, ethnic traditional birth attendants (midwives) and other village women contributed perspectives providing richly descriptive data. This ethnographic study was conducted during 6 weeks of immersed participant observation with primary data collection carried out through fieldwork. Data were analyzed to derive cultural themes from interviews and observations. Significant themes included (1) valuing motherhood, (2) laboring and giving birth silently, (3) giving birth within the comfort of home and family, (4) feeling capable of birthing well, (5) feeling anxiety to provide for another child, and (6) embracing cultural traditions. Listening to the voices of Hmong women enhances understanding of the meaning of childbirth. Gaining greater understanding of Hmong cultural beliefs and practices can ensure childbearing women receive respectful, safe, and quality care.

Perceptions of giving birth and adherence to cultural practices in Chinese women.

PURPOSE: To compare the childbirth experiences of Chinese women living in varied sociocultural contexts. METHOD: Qualitative study of 34 Chinese women who had given birth in their country of origin (the People's Republic of China [PRC] or Taiwan) and Chinese women who immigrated to the United States. FINDINGS: This research provides insights into the perspectives of mothers living in varied sociocultural contexts. Themes included expecting a child and defining birth expectations, experiencing giving birth, adhering to cultural beliefs and practices, and framing birth within sociocultural context. IMPLICATIONS FOR CLINICAL PRACTICE: There are cultural beliefs and practices associated with giving birth in all cultures, and because there is such rich cultural diversity in the United States, it is important for nurses caring for childbearing women to understand Chinese cultural beliefs and practices in order to provide culturally competent care.

Spirituality in childbearing women.

Childbearing is the ideal context within which to enrich spirituality. The purpose of this study was to generate themes regarding spirituality and religiosity among culturally diverse childbearing women. A secondary analysis was performed, using existing narrative data from cross-cultural studies of childbearing women. The following themes emerged from the data: childbirth as a time to grow closer to God, the use of religious beliefs and rituals as powerful coping mechanisms, childbirth as a time to make religiosity more meaningful, the significance of a Higher Power in influencing birth outcomes, and childbirth as a spiritually transforming experience. In clinical settings, understanding the spiritual dimensions of childbirth is essential. Assessments of childbearing women may include the question, "Do you have any spiritual beliefs that will help us better care for you?"

Giving birth: the voices of Ecuadorian women.

PURPOSE: The purpose of this ethnographic study was to describe the perceptions of Ecuadorian childbearing women BACKGROUND: No studies published in English could be found documenting the perspectives of Ecuadorian childbearing women about their birth experiences. METHOD: Thirty-two women who had recently given birth in Guayaquil, Ecuador participated in audiotaped interviews, which were analyzed as appropriate for ethnographic inquiry. RESULTS: "Enduring birth to obtain the gift" was the overarching theme. Supporting themes included caring for self and accessing prenatal care to have a healthy newborn; relying on God to ensure positive maternal/newborn outcomes; submission of self to healthcare providers because of fear, pain, and lack of education; and valuing motherhood. The focus was on the well-being of the child rather than the quality of the birth experience. IMPLICATIONS FOR CLINICAL PRACTICE: With a growing population of women of childbearing age immigrating into the United States from Central and South America, the need for culturally competent care is increasing. Sensitivity to the cultural beliefs and practices of Hispanic and other culturally diverse childbearing women is critical. Women's reliance on God to ensure positive outcomes should be respected. The provision of education and supportive care will help ensure positive outcomes in culturally diverse women.

Giving birth: the voices of Australian women.

BACKGROUND AND SIGNIFICANCE: Women's perceptions of childbirth are defined within sociocultural context. Listening to the voices of women is essential to increase nurses' sensitivity to the needs of childbearing women and help nurses provide culturally competent healthcare. PURPOSE: The purpose of this qualitative descriptive study was to identify Australian women's perceptions of giving birth. METHOD: Seventeen Australian women who had given birth in the past 12 months participated in audiotaped interviews. Trustworthiness of the findings was ensured. Themes were generated on the basis of rich narrative data. RESULTS: Themes included focusing on the moment of birth, being empowered by giving birth, defining the spiritual dimension of giving birth, having a diminished or traumatic birth, feeling concern for the child, coming to know the child, and receiving care: nurses making a difference. IMPLICATIONS FOR CLINICAL PRACTICE: Results confirm the findings of other studies suggesting that provision of educational resources and individualized nursing care creates a climate of confidence in childbearing women.

Giving birth: the voices of Ghanaian women.

Childbirth is significantly influenced by women's cultural perceptions, beliefs, expectations, fears, and cultural practices. Our purpose in conducting this focused ethnography was to determine the perceptions of Ghanaian childbearing women. Twenty-four mothers who received health care at the Salvation Army Clinic in Wiamoase, Ashanti, Ghana, participated in audiotaped interviews. Patterns of thought and behaviors were analyzed, describing the realities of the lives of Ghanaian childbearing women. Themes included centering on motherhood, accessing health care, using biomedicine, ethnomedicine, and spiritual cures; viewing childbirth as a dangerous passage; experiencing the pain of childbirth; and fearing the influence of witchcraft on birth outcomes. Culturally specific knowledge obtained in this study can be utilized by health care providers, health policymakers, and those designing health care interventions to improve the health and well-being of childbearing women in developing countries.

Parent Involvement in End-of-Life Care and Decision Making in the Newborn Intensive Care Unit: An Integrative Review.

Survival rates for very preterm and critically ill infants are increasing, raising complex ethical issues for health-care providers and parents who face the challenge of making end-of-life decisions for newborns. The purpose of this integrative literature review was to evaluate parental involvement in end-of-life care and decision making for their infant in the newborn intensive care unit. Findings revealed that establishing good relationships and clear communication between health-care providers and parents builds trust and eases stress placed on parents making decisions about the care of their infant. Palliative care programs provide support for parents and facilitate their decision making. Parents can be educated about how to communicate with health-care providers. Educating nurses on how to provide end-of-life care may also help improve support for parents during this difficult time. Additional research is recommended to examine parents' needs during and after end-of-life care decisions for their newborn.

Use of facilitated tucking for nonpharmacological pain management in preterm infants: a systematic review.

BACKGROUND: Neonatal care demands attention to interventions that effectively reduce pain with pharmacological and nonpharmacological methods in preterm infants during invasive procedures. PURPOSE: The aim of this systematic review was to determine the efficacy of facilitated tucking as nonpharmacological pain management in preterm infants. METHOD: Electronic searches were conducted using the following databases: Ovid, Blackwell Synergy, ScienceDirect, PsychINFO, and CINAHL and with the following key words: facilitated tucking, preterm infant's pain responses, and randomized clinical trials for the period of 1995 to May 2008. RESULTS: The search generated 15 articles; 5 articles fit to the criteria of the systematic review. The following outcomes were statistically significant: heart rate; increase in oxygen saturation; sleep-wake state; Premature Infant Pain Profile scores; and neonate infant pain scores. CONCLUSION: The studies reviewed provide important preliminary findings that suggest facilitated tucking may be beneficial to preterm infants in attenuating their responses to painful procedures.

Meanings of menopause: cultural influences on perception and management of menopause.

Attitudes and sociocultural perceptions provide the context within which women experience menopause. Cultural influences greatly affect how women perceive and manage their menopausal symptoms. Cultures may be categorized based on way of life, including traditional, immigrant, and modern. Varying perceptions and symptom experiences are described, including modifiable and nonmodifiable factors that affect the level of distress women feel with menopause. Helping women actively participate in management of menopausal symptoms including self-care strategies will contribute to feelings of control of menopausal symptoms and overall health. By using the highest levels of evidence regarding management of menopause, becoming familiar with the cultural and psychosocial influences of menopause and then empowering women to make decisions regarding management, health care providers can improve their care of perimenopausal and menopausal women.

Dutch women's perceptions of childbirth in the Netherlands.

PURPOSE: To explore the lived experience of childbirth in Dutch women who had given birth at home in the Netherlands. METHODS: Qualitative study using audiotaped interviews with 14 women. RESULTS: Themes included the advantages of giving birth in the home, where the women felt more in control of their environment; the difficulty and normalcy of the pain associated with giving birth; the feelings of fulfillment and empowerment that come with childbirth and motherhood; and the importance of the supportive role of the midwife-caregiver. NURSING IMPLICATIONS: Women in a culture different from that of the United States who gave birth at home felt fulfilled and empowered by the experience. These results can help U.S. nurses more fully understand the meaning of childbirth in a different culture and may help identify possible improvements in the design of care for women and newborns in the United States.

Giving birth: the voices of Russian women.

PURPOSE: To gain an understanding of the meaning of childbirth to women living in St. Petersburg, the Russian Federation. STUDY DESIGN AND METHOD: Twenty-four Russian women who had given birth in the past 6 months participated in this phenomenological study and were interviewed and audio-taped about the meaning of childbirth. Data collection and analysis occurred concurrently. RESULTS: The Russian sociocultural context of childbirth was identified in specific themes: (1) adhering to cultural traditions, (2) accessing information, (3) maintaining a healthy lifestyle, (4) articulating the spiritual and emotional meaning of giving birth, and (5) transforming as a mother and a person. Study participants reported reading extensively during pregnancy as well as accessing Web-based information about childbirth. Women chose to give their newborns traditional Slavic names and have their infants christened. CLINICAL IMPLICATIONS: The findings of qualitative studies can be used to guide clinical practice, because they provide rich data about essential life events and reactions associated with them. Women from Russia are emigrating to countries all over the world, and thus, their cultural views of childbirth are essential knowledge for the provision of appropriate nursing care. With dramatic socioeconomic and political changes occurring over the past 15 years, along with major changes in healthcare delivery systems, listening to the voices of Russian childbearing women giving birth is vital information for nurses working in maternal-child health settings.