“Muslim Australians value their children,” wrote Danna Vale, a Member of Parliament and of Howard’s Liberal Party in Australia. Moreover, the Muslim girl from the Philippines in the given situation is just one of the many Muslims who gave birth in Australia where culture and tradition differences became an ongoing issue. In fact, Babette Francis, head of the anti-feminist Endeavour Forum once emphasized that “”while I respect Muslim support for pro-family and pro-marriage policies, especially at the UN, the negative side is that they also agree with polygamy”. However, Muslims believe that pregnancy is fated by Allah subhannahu wa ta’ala and it is an innate condition.
Moreover, Islam reveres and appreciates women who give birth, and this honor can be reclaimed by a Muslim woman by handling their pregnancies and childbirth with ‘iman (faith), tawwakul (complete trust in Allah), education, and common sense. They believe that it is important to trust one’s instincts to avoid having fears and this will create a positive outcome for the pregnant mother and her child. The pregnant mother should also accept that her pregnancy is a gift and not as a sort of punishment. So, how does a Muslim mother deals with her pregnancy in a foreign land and as a nurse how can one help in facilitating a safe pregnancy for her and her family taking into consideration her cultural and religious status?
Meanwhile, Madeleine Leininger, the founder of Transcultural Nursing reiterates that “The culture care needs of people in the world will be met by nurses prepared in transcultural nursing.” A humanistic and scientific area of formal study and practice in nursing which is focused upon differences and similarities among cultures with respect to human care, health, and illness based upon the people’s cultural values, beliefs, and practices, and to use this knowledge to provide cultural specific or culturally congruent nursing care to people. Leininger (1991) notes the main goal of transcultural nursing is to provide culturally specific care.
Thus, it is important for the nurse to do proper assessment of the client to know more about the specific needs of the client and what considerations to take in order to show respect to the client’s cultural and religious’ preferences. The interrelationships of specific cultural nursing care are being studied and analyzed by transcultural nurses. By looking at it in the nursing perspective, positive goals will be derived. These transcultural nurses are competent, equipped with enough knowledge, educated and has a wide field experience that will help them cater the needs of the culturally diverse clienteles from all over the world. their knowledge on different cultural variations, unique traditions, attitudes, values and beliefs will help them derive information that will be the basis for their goals in rendering individually appropriate nursing care. Meanwhile, a research in nursing revealed two perspectives that are basically unheard of and indistinctly recognized in cultural care and health concerns. These are the emic perspective and etic perspective which is centered on confined, native and insider’s culture and concentrates on the outsider’s world specifically on professional views respectively.
Moreover, some things to be considered in caring for a pregnant Muslim mother in Australia includes that a female provider should examine during the prenatal period and drapes should be used at all times but a male doctor can examine the patient only in the presence of her husband or another female. It would also be helpful to use the services of an interpreter to address the language barrier problem and enough time should be given in explaining laboratory tests, procedures and compliance. Further, it is also wise to identify a Muslim healthcare provider and inform the patient of her rights to choose her physician.
Moreover, since the Muslim mother doesn’t any idea how to avail of appropriate professional as well as folk health services, it is important for the nurse to give the mother the picture of the health care setting in Australia especially in the trend of childbirth process. Furthermore, the trend of birthing in Australia has jumped from evidence based practice to what is practical and best for both the mother and the child. In some studies conducted, the following results are imminent: women who gave normal birth without intervention comprised at least 80% while only bout 18% belong to the low risk who gave birth in private institutions and but did not require serious intervention. On the other hand, of the 50% Australian woman who gave birth to their first babies and were judged by doctors as not capable of starting labor, 47% of the low risk had spontaneous labor. The result was appalling. Another important consideration is that epidural block has been popular among low risk first time mothers which can decrease labor pains however some may not know the associated risks. The presented figures will help the mother gain idea as to the trend in Australia.
It is therefore noted that home birth is a personal choice of woman in Australia. In fact, about 80% of women who had no medical complications utilize the planned home delivery which according to obstetricians is absolutely safe. However, there were studies which discourage such due to the some dangers that may arise. According to Crotty (1990), a study on the Australian television program ‘Lateline’ Dr Brunello several years ago tried to secure his position on anti-homebirth by data presentation from research in South Australia which revealed that perinatal mortality is higher in homebirth but some believed that there was distortion of data. Still, more recent publication on homebirth in Australia has methodological flaws and according to Wagner (1998) “It is well known in Australia that the reason for the several shifts in data collection methods in this study (which effectively eliminated any possibility of scientific validity) is because so many midwives felt betrayed by the researchers that they refused further participation in the research. It is intellectually dishonest not to report this fact in this paper.”
Moreover, discouraging a low risk woman in choosing what place to give birth by withholding pertinent information is biased and in a way deceitful since the basic human right is denied. Each woman, whatever is her cultural background should have access to full and unbiased information and no doctor or hospital has the right of doing so. Imposing their own medical perspective to their clients believing that they know what’s best for them is pure medical fascism. For Muslims where giving birth is one important event, it is necessary that the mother and the members of the family’s choices will be respected as to matters of birthing and childcare processes and it is the duty of the nurse or any member of the medical team to honor their wishes.
However, due to the negative and alarming misinformation about how risky birth is another alternative many women choose is the security on a birthing institution. With this, the nurse can inform the mother about an alternative birth center (ABC) which actually is not a hospital and staffed by midwives. Here the woman is in power of giving birth, assisted by a midwife and protected by an institution. For one thing, an ABC is not controlled by a hospital instead the woman herself is empowered by her own childbirth. So she is in control of what will happen to her and her baby. The midwives in an ABC use their own protocols and not with that of the doctors.
Furthermore, there are several differences in terms of routines between an ABC and in the hospital. For one thing, the woman is in control in an ABC which means the care is individually appropriate while in the hospital, routines are uniform to all clients and is controlled primarily by the physician. Moreover, the hospital may put emphasis on complications while an ABC dwells on what is normal thus labour pains is perfectly normal in an ABC as hospital views it something evil thus medications are used to sweep it away. Pain in an ABC is dealt with scientifically proven and non pharmacological methods like as presence of family, changing position and moving about, immersion in water, massage and continuous presence of the same birth attendant.
Meanwhile, most hospital use powerful drugs to induce births which may have harmful consequence but ABC uses walking and sexual stimulation as stimulants and most importantly the care process in an ABC is continuous since the midwife will be present all throughout the labor period. You cannot expect such in a hospital setting since there is a rotation of duty schedules among the staff and after giving birth the baby will stay with the mother unlike in the hospital where the baby will be taken away to be examined for example.
In conclusion, a good nurse is able to care for her client no matter what culture she belongs to. What is important is the feelings of understanding and empathy will be conveyed clearly. In the case presented, the information given by the nurse will greatly help the pregnant Muslim woman in choosing what method of delivery to choose knowing that hers is not an isolated case and her cultural background will never be a barrier for her in acquiring optimal medical care.
REFERENCES
Bastian H, Keirse M, Lancaster P “Perinatal death associated with planned home birth in Australia: population based study”. (BMJ Vol 317, 8 Aug. 1998 )
Crotty M, Ramsey A, Smart R et al. “Planned homebirths in South Australia 1981 – 1987: a descriptive study.” (Med J Aust 153, p 664-671, 1990)
Geiger, J.N. & Davidhizar, R.E. Transcultural nursing: assessment in intervention. (St. Louis: Mosby-Year Book, 1991)
Leininger, M. Transcultural nursing: the study and practice field. (Imprint, 38(2), 55-66. 1991).
Leininger, M. Qualitative research methods in nursing. (New York: Grune & Straton, 1985)
Stephenson P, Ford Z, Schaps M “Alternative Birth Centers in Illinois: A resource guide for policy makers” (University of Illinois at Chicago Center for Research on Women and Gender, and the Health and Medicine Policy and Research Group. June 1995)
Tripp-Reimer, T & Dougherty, M.C. Cross cultural nursing research. (Annual Review of Nursing Research, 3, 77-104,1985).
Wagner M “A Critique of: Bastian H, Keirse M, Lancaster P; Perinatal death associated with planned home birth in Australia: population based study”. (British Medical Journal Vol 317, 8 August 1998)
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