What cultural beliefs must the nurse keep in mind when caring for a Chinese client in labor

Demographic characteristics

The study involved 13 post-partum women who had delivered per vagina within the last two months. They were aged 18 to 35 years and were all Christians. With the exception of one participant, all the women were married.

Description of themes and sub-themes

The themes were: Religious beliefs and practices (prayer, singing, thanksgiving at church, fellowship and emotional support); Pastors’ spiritual interventions in pregnancy (prayer and revelations, reversing negative dreams, laying of hands and anointing women); Traditional beliefs and practices (food and water restrictions, tribal rituals); Religious artefacts used in pregnancy and labour (anointing oil, sticker, blessed water, blessed white handkerchief, blessed sand, Bible and Rosary); family influence and secrecy.

Laying of hands involves the physical touch of pastors on women during prayer and in the process, they may anoint the women by applying anointing oil or blessed olive oil mostly on the head or forehead.

Religious beliefs and practices

This theme describes sub-themes such as prayer, singing, thanksgiving at church, fellowship and emotional support during pregnancy and labour.

Prayer

The women in this study had a number of beliefs associated with pregnancy and delivery. The central belief was the likelihood of a negative outcome of pregnancy. Therefore, the women prayed to prevent any complications. They were of the view that pregnant women should be cautious as extra forces or evil spirits come to play during pregnancy. It was emphasized that pregnant women should pray.

‘I know some pregnant women who did not pray or did anything spiritual; so, when they went to the labour ward, they came back alone and some died. Therefore, when you are pregnant, there are some extra forces that fight you in the spirit, and as such, you need to be cautious; extra cautious!’ (PPW8)

The women prayed believing that God will help them go through labour successfully and minimize their pain because the pain was unbearable. In those instances, the thoughts and concerns about the baby were not paramount. Some of the women prayed to God because they were not sure of their survival during labour.

‘I was praying, at a point I just said God should bring out the baby and I will live; because, I didn’t know whether I will be able to survive the labour because the pain was very severe’. (PPW12)

In addition, women prayed to God so they could deliver peacefully. ‘I prayed when I was at the hospital that God should be with me to enable me deliver in peace’ (PPW7). Also, prayer for women was done to ensure the protection from the blood of Jesus against accident or tragedy caused by the devil. The blood of Jesus was believed to be a potent protector although it was not seen physically. ‘…the pastors pray that the blood of Jesus should prevent all actions of the devil and when the time is right everyone should deliver safely; whatever tragedy or accident, God should prevent it’ (PPW2). Pregnant women also prayed that God takes control of their delivery process when labour starts.

‘I prayed to God to take away the human nature of the doctors and the nurses and to take absolute control over the whole delivery process’. (PPW7)

Women in labour prayed that God will relieve them of severe labour pain. ‘I prayed that God should free me from the severe pain I was going through’. (PPW12)

Some of the women who were initially scheduled for a caesarian section prayed for a normal delivery and they believed God answered their prayers when they did not undergo the surgery. The health care providers were surprised that they were delivered of their babies spontaneously.

‘I was just thanking God and telling Him that He has done what I wanted for me. I was able to give birth myself without an operation. So when I was leaving the labour ward, the doctors and midwives were all surprised and even the doctor passed a comment that “Eii, someone that we were going to operate upon and in less than 30 minutes you have delivered safely” he was so surprised’. (PPW3)

Some of the women prayed for themselves during pregnancy for safe delivery. The personal prayers were done at home or in the church.

‘At times I wake up at dawn and before bed time and worship God on my own. (PPW4); ‘when we had a programme at Church, I usually went and when they asked us to pray, I prayed about my safe delivery without anybody praying for me’. (PPW3)

Singing

In addition to the prayer, some of the women sang quietly during labour and were asked by the midwives to keep quiet as they disturbed other women. During the singing, some women were thinking about the severe pain associated with the labour rather the unborn baby.

‘a midwife warned me that I am not the only one on the ward; that I was making noise because I used to sing when praying; that was what I think made the noise’. (PPW4)

‘I tell God it is not by my strength but His; so, He should help me deliver safely. And I also sang quietly. …during the singing, I was thinking about the pain and how God was going to save me. …the pain was the first thing on my mind; I wanted the pain to reduce because it was unbearable. So at that time, seriously, I did not think much about the baby’. (PPW8)

Thanksgiving at church

Following the thanksgiving at the labour ward, most of the women went to church to give testimonies for their safe delivery. ‘I went to give a testimony in church after my safe delivery’ (PPW2).

The women were either prayed for in the church or their family members prayed for them. Some of the women received instructions from those who prayed for them to ensure their safe pregnancy and delivery. Therefore the thanksgiving at church showed appreciation for the spiritual help received.

‘…the pastors urged the rest of the congregation to assist us (pregnant women) in prayers for safe delivery’. (PPW8); ‘…in my church, they call the pregnant women to the front to pray for them during church service. So I went to church to thank God and all those who helped me in prayer’. (PPW2)

‘…my sister was in a prayer force and they were praying for me. … so if I had to go somewhere, she told me to anoint yourself (apply blessed olive oil on the body) and I did. After the delivery, I went to church to God and the prayer force’. (PPW8)

Fellowship and emotional support

Some of the women felt that it was consoling or reassuring to know that others are praying during pregnancy. This consolation is enhanced if it is accompanied with personal relationship with the pregnant women especially those having challenges with their pregnancies. In this instance, a participant was angry with her church when they did not show the needed concern during pregnancy.

‘It’s consoling that somebody is praying for you, somebody is thinking about you and checking on you, I think it is really necessary. I was angry with my church when they didn’t check on me; they did not give me any attention when I was having challenges with my pregnancy; I thought they had deserted me and I was not happy’. (PPW12)

Pastors’ spiritual intervention in pregnancy

This theme describes the interventions received from pastors during pregnancy. Sub-themes such as prayer and revelations, reversing negative dreams, laying of hands and anointing women are described.

Prayer and revelations

Most of the women sought prayer support from pastors during pregnancy. The men of God had revelations about the pregnancy and prayed for the women. Some of these revelations related to witchcraft that aimed at a negative outcome of pregnancy.

‘…the pastor said that someone from my paternal family wanted to give my child witchcraft so he prayed for me and sometimes when he saw any vision about me, he called me and prayed for me as the church members also prayed for me. He saw in a vision that the witches had planned to terminate my pregnancy so the pastor prayed to prevent it’ (PPW6)

In other circumstances, pastors were consulted when women could not feel foetal movements. The pastors in such situations revealed that the baby was tied in the womb after a hospital assessment showed a big baby. In addition to the prayers, a specific bible quotation was given to the women to use during prayers.

‘…at 7 months I could not feel my baby move so when I went to the hospital and they said the baby was big that was why; so, I went to see my pastor and he prayed for me and told me that the baby had been tied up in my stomach’. He gave me a quotation that I should use to pray. …I cannot remember the quotation’. (PPW2)

Reversing negative dreams

Other women had bad dreams during pregnancy and the pastors prayed with them even in the night. The pastors sometimes prayed in tongues (using different and unfamiliar language that is believed to be a gift of the Holy Spirit). The prayers were aimed at averting any negative consequences on the pregnancy.

‘I had a dream that I had been delivered of my baby in the 7 th month and someone took the baby away from me. … I told my pastor about the dream and he prayed for me. …he used to call me in the night; at times 12 midnight, 2 or 3 am to pray for me because he said that was when the witches are active. He prayed in tongues and I responded Amen! He said he saw in a vision that there was a plan to terminate my pregnancy so he prayed to prevent it’. (PPW4)

Laying of hands and anointing women

In the quest to pray for the women for one reason or another, some pastors laid hands on the abdomen and applied blessed olive oil or anointing oil on it.

‘The pastor asked me to lie down and he prayed for me and I used a cloth to wrap my lower abdomen and my abdomen was exposed. Then, he used the anointing oil on it. …since people were in the church, they were also praying and he poured some anointing oil in his hands and placed it on my abdomen and prayed’. (PPW6)

In one instance, the pastor’s revelation showed that there was nothing wrong spiritually with the pregnancy. ‘…the pastor said there was nothing wrong’ (PPW2). However, a few of the women did not go to any pastor for prayers. ‘…I never went to a pastor to pray for me when I was pregnant’. (PPW3).

Traditional beliefs and practices

This theme describes the traditional beliefs and practices women observed or undertook during pregnancy. Sub-themes of food and water restrictions and tribal rituals emerged. Women who reported traditional practices also went to church in addition to the traditional practices.

Food and water restrictions

Some traditional beliefs associated with pregnancy were that, pregnant women should not eat or drink in public to avoid effects of evil spirits.

‘I was told not to eat or drink in public to avoid evil eyes; that was a traditional belief my mother told me so I was following it.…I wasn’t eating in public and I didn’t eat any food cooked by somebody; Apart from the one I cooked myself or maybe my mother or somebody closer to me cooked, I didn’t eat from any other source; even those on sale. (PPW12).

Tribal rituals

A participant described vividly a traditional practice for first pregnancy that was mandatory for her tribe. She was camped for 3 days, tied, bathed with urine, and asked to buy shallots at dawn without talking to anyone. This ritual was necessary to ensure ancestral protection, a safe delivery and a normal baby.

‘…a few days to my delivery, I was camped in a room for 3 days. During the period, I was tied with ropes and bathed with urine. On the third day, they brought me out early in the morning around 5:30 am and said I had to go and buy some small onions (shallots) and I was warned not to talk to anyone on my way. They gave me 3Gh Cedis in coins. Also, they said when I get to the market, I should not ask any questions; I should just put the money down and take the shallots; so, I did that and I returned and they said the onions were to be used immediately after I give birth. So, when I gave birth, they used it to prepare food for me the next morning. It is believed that if a woman does not do the ritual, the child will be abnormal. It is a traditional ritual that had been there for a long time …it is done for only the woman’s first pregnancy. …when they were doing it they called on the gods that if I have wronged anyone or someone has anything against me, my fore fathers or ancestors should intervene so that nothing bad happens to me. The ceremony was done by older women in my tribe’. (PPW6)

Religious artefacts used in pregnancy and labour

A number of religious artefacts were used by women to enhance their protection and ensure safe delivery. This theme describes the religious artefacts women used in pregnancy and labour such as anointing oil, blessed water, blessed white handkerchief, blessed sand, Bible and Rosary.

Anointing oil

Some women prayed over olive oil or anointing oil themselves and anointed themselves. The areas of the body anointed included the forehead, head, abdomen and feet. The word of God was added during the prayer over the oil perhaps to increase its potency.

‘I just prayed over the anointing oil, believing that it works. I know that the anointing breaks the yoke of the devil; I have that faith. So sometimes I open the bible to support the anointing with a verse and I just anoint myself. …I apply it on my forehead and on my baby (tummy) or sometimes from my head to my feet or my feet alone’. (PPW8)

Some of the women used anointing oil that was blessed by their pastors to prevent maternal and neonatal death. The use of the anointing oil was not regular because of lack of faith in it

‘The pastor said I should use the anointing oil to smear my abdomen and that will ensure my normal delivery; if not, I will die with my baby. …though I didn’t believe in it, my husband did, so I did it for some time and I asked myself “what is the use of this?”. So, I stopped’. (PPW12)

Some women were asked to add the anointing oil to their bathing water and use it for bathing.

‘The pastor said I should pour some of the oil in the water I use to bath and then bath with it. I did it for about a week and I didn’t see any use of it, so I stopped’. (PPW12)

Sticker

Women used stickers of pastors and churches during pregnancy and labour. Some women placed the sticker in the hair net they used to cover their hair on the labour ward while others rubbed it on the abdomen. Some women also placed the stickers in bottles of water they drank.

‘a friend in labour had a sticker of her pastor in her hair net and after bathing, she would rub her belly with the sticker for a while and would then start smearing the anointing oil on her belly. …she also put one in bottled water and was drinking on the ward; I told her that the use of stickers alone without prayers cannot give her the desired spiritual protection’. (PPW8)

Blessed water

Most women in this study used blessed water (water which had been prayed over by their pastors) as a religious artefact. The blessed water was sometimes used to wash the face. ‘I used the blessed water to wash my face for a while and stopped’ (PPW13). Some women did not drink any ordinary water which may be bottled or in a sachet unless they had been blessed or prayed over by their pastors.

‘I remember my first pregnancy, I wasn’t taking ordinary water, I bought a box of mineral water and we prayed over it before I drank it. I wasn’t allowed to take in any other water; …even if I was thirsty and you gave me water because my water was finished, I won’t drink it. I went home and took mine’ (PPW12)

Blessed white handkerchief

In addition, pregnant women were also given blessed white handkerchiefs to be placed under their pillows for protection. Some of the artefacts were used under the influence of mothers. Some husbands however were not aware of such artefacts.

‘I also used a white handkerchief under my pillow; the pastor prayed over it and gave it to me to place under my pillow for protection’. (PPW13)

Blessed sand

A woman reported using sand that was blessed by the pastor and the woman believed that it was safe to use. Water was added to the blessed sand and the solution was sieved and used for enema during pregnancy.

‘The pastor blessed sand for me; he prayed over it for me to use …I had faith in it that when I use it, nothing will happen to me and it will work as the pastor said. He asked me to add water to the sand, sieve it and use it as enema from time to time and I did’. (PPW2)

Bible and rosary

Some women used the Bible and rosary to pray during pregnancy. A few women did not believe in pastors praying for them. These artefacts were believed to provide protection for the pregnant woman. ‘I used just the Bible to pray; … I don’t believe in going to pastors to pray for me’ (PPW12). ‘…I used the rosary to pray; I had the rosary on my neck, I slept with it; I had the scapular too for protection’ (PPW11); ‘I usually used my rosary to pray’ (PPW13).

Family influence and secrecy

Some pregnant women used anointing oil as a result of influence from their mothers although their husbands did not approve of such religious artefacts. A husband instructed that the woman should not allow the pastor lay hands on the abdomen during prayers. However, the woman on her own accord used the anointing oil on the abdomen in the morning, when going out and on the forehead for protection. The anointing oil was not sent to the labour ward because of the pain.

‘My mum took me to a fellowship she worships with. My husband hates it when someone prays for you. He believes that you can pray for yourself and you will be saved because you do not know what power the pastor is using. So, when I went, he told me not to allow anybody to put the hand on my abdomen. The pastor gave me anointing oil that he had prayed over. When I wake up in the morning, I just apply some of the oil on my abdomen, before I go out and even on my forehead just to protect me; that was my belief. When I was going to the labour ward, I did not take the anointing oil with me because that time my mind was on the pain and I forgot’. (PPW9)

In another instance, the woman applied the anointing oil on the abdomen to please the husband and did not use it when she was alone. ‘I wasn’t staying with my husband; so, when I went to his place, I tried to use the anointing oil but when I got to my station, I forgot about it’. (PPW11)

‘My husband never saw me use the blessed white handkerchief; …and I used the blessed water because I didn’t want to disobey my mother’. (PPW13)

A framework that describes the themes is presented in Fig. 1: Religious beliefs and practices in pregnancy and labour.

Fig. 1

Religious beliefs and practices in pregnancy and labour

Full size image

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