Traditional beliefs and practices in pregnancy, childbirth and postpartum: A review of the evidence from Asian countries

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INTRODUCTION: Asian women suffer the largest proportion of the world’s maternal deaths. To reduce this, policymakers and healthcare providers must encourage women with traditionally low rates of maternal health care utilization to access services.OBJECTIVE: The purpose of this study is to provide a comprehensive review of the most common traditional practices in Asia relating to pregnancy, childbirth and the postpartum period.DESIGN: We conducted a literature search of articles: a) focusing on Asia; b) relating to pregnancy, childbirth or postpartum, c) relating to traditional beliefs and/or cultural practices; and 4) published in English in the year 2000 or more recently.FINDINGS: A total of 74 articles are included in this review; 20 articles related to pregnancy, 44 to childbirth, and 45 to postpartum. More than one-half (38) of the articles focused on South Asia and 13 related to China. In the pregnancy category, the majority of the studies focused on dietary recommendations and behavioral taboos. For the childbirth category, many articles examined beliefs and practices that helped to explain women’s aversion to institutional births, such as preference for traditional birth positions, and fear of medical interventions. In the postpartum period, confinement was common because postpartum women were perceived to be weak, fragile and vulnerable to illness. Other prevalent beliefs and practices across Asian countries included massage, the state of pollution after childbirth, the use of traditional healers and traditional medicine and herbs, beliefs relating to hot/cold imbalance, behavioral taboos, magic, and superstition.KEY CONCLUSIONS: Many Asian women continue to practice a wide range of traditional beliefs and practices during pregnancy, childbirth, and the postpartum period. More information is needed on the benefits of formal maternal healthcare services; such educational programs should be geared towards not only women but also husbands, parents, and in-laws. By recognizing and appreciating common local beliefs, providers can be better positioned to provide culturally competent care. Instead of reducing the choices available to women during the birth experience, providers should understand, respect, and integrate cultural interpretations of childbirth and the needs of women and their families.