Cultural Diversity in Childbirth Practices of a Rural Community in Southern Nigeria

Introduction: Knowledge of cultural diversity is important for nursing/midwifery care as these address ethnic and racial differences between providers and consumers of health care, thus, can strengthen and broaden the healthcare delivery system. In a typical nurse/midwife-patient/client encounter globally, there is interplay of three Cultural systems namely, culture of the nurse/the profession, culture of the patient/client and that of the health care system. Multicultural nature of Nigeria influences birth practices. This paper presents findings of a 'fact-finding' phase of action research project which explored understanding of childbirth practices as part of prevention of maternal mortality study in a rural community. Methods: Ethnography design was utilized informed by participatory action research. Data were generated through twenty-nine in-depth individual interviews of childbearing-age women, four focus group discussions with other childbearing-age women, menopausal women/mothers-in-law and traditional birth attendants. Practices of five traditional birth attendants and one midwife were observed. Participants were selected through purposive and snowball sampling. Results: Thematic data analysis revealed diversity in childbirth practices between the traditional indigenous culture and nursing/midwifery culture depicted in the following themes: children having children; nutritional taboos; imposition of decision on care; preference for traditional birth attendants; spirituality as source of safe childbirth; position for delivery; utilization of traditional sanitary towels; care in delivery emergencies; midwives ethnocentrism and culture-imposition. Findings were inputted into the planning phase of the action research for critical reflection and action. Conclusion: Cultural diversity explicitly exists in the nurse/midwife and client interaction in this setting. It is recommended that nurses/midwives should deliberately seek to understand the culture of the people and adopt the harmless ones. Where culture is inimical to health, clients should be democratically and collaboratively motivated to critique their practices with the hope of possible repudiation. This study has implication for the provision of culturally competent care in childbirth.