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

Lynn M Sibley; Daniel Hruschka; Nahid  Kalim; Jasmin Khan; Moni Paul; Joyce Edmonds; Marjorie A.  Koblinsky

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Correspondence and reprint requests should be addressed to: Dr. Lynn M. Sibley Associate Professor Director, Center for Research on Maternal and Newborn Survival Nell Hodgson Woodruff School of Nursing Emory University 1520 Clifton Road NE, Suite 436 Atlanta, Georgia 30322 USA Email: lsibley@emory.edu Fax: +1-404-727-9676

The authors thank Lauren Blum and Roslyn Botlero for their assistance during the pre-testing phase of the study and Aasma Afroz, Nargis Farhana, and Shahana Parveen for their role in its implementation. The authors also thank Gery Ryan, Clarence Gravlee, and Joe Henrich for their advice in applying cultural consensus modelling to the problem of PPH. The authors are solely responsible for the views expressed in the paper, which, in no way, reflect the official opinion of the funding body.

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This project was made possible through the Robert W. Woodruff Health Sciences Center Foundation, Emory University, Atlanta, Georgia, USA.

Keywords:

Anthropometry
Cultural
Maternal mortality
Morbidity
Postpartum haemorrhage
Bangladesh

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

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

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Journal Title:

Journal of Health Population and Nutrition

Volume:

Volume 27, Number 3

Publisher:

Icddr:b | 2009-06, Pages 379-390

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Article | Final Publisher PDF

Permanent URL:

http://pid.emory.edu/ark:/25593/fkk4x

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.

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This is an Open Access article distributed under the terms of the Creative Commons Attribution 2.0 Generic License ( http://creativecommons.org/licenses/by/2.0/), which permits distribution of derivative works, distribution, public display, and publicly performance, making multiple copies, provided the original work is properly cited. This license requires credit be given to copyright holder and/or author.

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

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