study made a new look into existing practice of care of mother during pregnancy
and lactation in neglected population predominantly among Muslim, indigenous
and lower caste in Kapilvastu district of Nepal. Early marriage, early
pregnancy and multiple pregnancies are common socio-cultural practices which is
still prevalence in the community.
usually go to check pregnancy only for Tetanus injection. The main reason for
not visiting check-up is due to family belief that it is ‘not necessary’. The
husband feels shyness if his wife goes to health facility to see the service
providers. The additional foods during pregnancy are not compulsion by the
family and women herself. Pregnant women are mostly fed with normal food as
usual. Supplementary and more nutritious food during pregnancy are provided
especially among economically affluent families. Social belief is that better
nutrition during pregnancy will increase baby size which may cause difficulty
in delivery and requires operation. Family care and support during pregnancy is
low in economically backward communities. Women from poor and Dalit households
have high workload during pregnancy.
deliveries are more common in compare to institutional deliveries 33.4%.
Delivery at health facility is not necessary’, ‘not customary’ and ‘husband or
family did not allow to go health facility’ as mother in law delivered her many
child at home. They try all measures in home; if not succeed then only go to
hospital. Women still have their babies at home because of the traditional
practice of giving birth at home due to lack of money for transportation
facility. Women’s low autonomy to decide on maternal health issues could be one
of the reasons for low institutional delivery. Unfortunately, women in
Kapilvastu district were less aware on danger signs during pregnancy and
delivery, and some of the lives threating signs are considered normal. Women
who had made sufficient antenatal visit were more likely to deliver at health
preferred to have maternity services from local traditional practitioners called
Chamain[i] over professional services. The Chamaini
helps them in their own home together with family members; they also do
massage, and bathing of women and baby. Family members, especially mother in
law and relatives also support the women during delivery. The study also
revealed that mal-practices in the community are high during delivery. eg, when
women find difficulties in removing placenta after birth, there is practice of putting
mother’s hair in the mouth. People believe that this cause vomiting which
results force in uterus and hence placenta is removed.
the place of birth, massage with heated mustard oil to the women during
postnatal period is common. Postnatal women are provided to take local made
sweet soup called ‘Veli’ [ii]soup, which people believe will
increase breastmilk and also accelerates uterus constriction. In Tharu culture
practices providing to take chilly soup to recently delivered mothers for
betterment of mother and child.
during postnatal period receive less care and support from the family if the new-born
is female child. The care is even less if the women is repeatedly giving birth
to female child.
than50% of the women are not aware about danger signs during pregnancy. The
symptoms such as swelling, vaginal bleeding, dizziness, fever and headache were
not considered as threats to the health.
home delivery, cord cutting is done by Chamain, until and unless she arrives.
The most frequently mentioned cord care by applying naval cream (36.3%),
followed by oil (19.0%) and Kerosene (17.3%) and ashes. Around 47% of the new-borns
bath within 24 hours of birth among Kurmi and Dalit ethnicities. In Dalit[iii] communities, where there is belief
that new-borns are contaminated with dirty blood are bathed immediately after
feeds are given in 45% of the neonates; most common being sweet liquid (60.7%).
There is widespread belief that such sweet foods might be more energetic and
child will be able to suck breast milk easily. Other pre-lacteal foods include
animal milk and plain water. Pre-lacteal feeding are more prevalent among
indigenous (54.3%), Muslim (46.7%) and Dalit (44.9%).
Women herself hardly make decision to seek maternal care by themselves. Husbands and mothers-in-law were the one who have final saying in such decisions. Very low proportion of women alone had final saying in decisions related to whether to have another child (5.0%), going for ANC visit (9.3%) and place of delivery of the baby (8.7%).
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