Cultural Theories of Postpartum Bleeding in Matlab, Bangladesh: Implications for Community Health Intervention

• Type of Material: Article
• Authors: Lynn M Sibley, Emory University; Daniel Hruschka, Santa Fe Institute; Nahid Kalim, Public Health Sciences Division; Jasmin Khan, Public Health Sciences Division; Moni Paul, Public Health Sciences Division; Joyce Edmonds, Emory University; Marjorie A. Koblinsky, Public Health Sciences Division
• Language: English
• Date: 2009-06
• Publisher: Icddr:b
• Publication Version: Final Published Version
• Copyright Statement: © INTERNATIONAL CENTRE FOR DIARRHOEAL DISEASE RESEARCH, BANGLADESH
• License: Creative Commons Attribution 2.0 Generic
• Final Published Version (URL): http://www.jhpn.net/index.php/jhpn/article/view/502
• Title of Journal or Parent Work: Journal of Health Population and Nutrition
• ISSN: 1606-0997
• Volume: 27
• Issue: 3
• Start Page: 379
• End Page: 390
• Grant/Funding Information: This project was made possible through the Robert W. Woodruff Health Sciences Center Foundation, Emory University, Atlanta, Georgia, USA.
• Keywords: Anthropometry; Maternal mortality; Bangladesh; Cultural; Morbidity; Postpartum haemorrhage
• Research Categories: Health Sciences, Obstetrics and Gynecology; Health Sciences, Education; Health Sciences, Nursing

Abstract

Early recognition can reduce maternal disability and deaths due to postpartum haemorrhage. This study identified cultural theories of postpartum bleeding that may lead to inappropriate recognition and delayed care-seeking. Qualitative and quantitative data obtained through structured interviews with 149 participants living in Matlab, Bangladesh, including women aged 18-49 years, women aged 50+ years, traditional birth attendants (TBAs), and skilled birth attendants (SBAs), were subjected to cultural domain. General consensus existed among the TBAs and lay women regarding signs, causes, and treatments of postpartum bleeding (eigenvalue ratio 5.9, mean competence 0.59, and standard deviation 0.15). Excessive bleeding appeared to be distinguished by flow characteristics, not colour or quantity. Yet, the TBAs and lay women differed significantly from the SBAs in beliefs about normalcy of blood loss, causal role of the retained placenta and malevolent spirits, and care practices critical to survival. Cultural domain analysis captures variation in theories with specificity and representativeness necessary to inform community health intervention.