Robin Kartchner and Dr. Lynn C. Callister, Nursing

Women across the world share in the same biological process of childbirth. However, their experience with childbirth can vary widely depending on their cultural and spiritual background. The quality of care a woman receives during and after her pregnancy is deeply influenced by the understanding of these factors that the nurse brings to their interaction (1). This research built on previous studies of women from other cultures (2) by interviewing Chinese women in China about their childbirth experience.

Interview questions were drawn from a review of the literature (3). The questions, consent form and demographic questionnaire were translated by bilingual Chinese people. All subjects were asked to fill out the consent and demographic forms. One of the mothers refused to sign and fill out the forms. The interviews were recorded on cassette tape. Currently, all interviews have been translated with the help of a native Chinese speaker.

During June and July 2000, eleven women were interviewed: two from Southern China (Guilin and Chongqing) and nine from Beijing. Of the eleven women, all had given birth to their first child within five months of the interview. The youngest newborn was two days old. The oldest was five months old. The new mother’s ranged in age from 26 to 36 years old.

Originally, I intended to find thirty women to interview who had given birth within a month of the interview. Operating under limited time and cultural restrictions, this ended up being an ambitious goal. Women in China tend to follow the traditional practice of zuo yue zi, or, “sitting the month”. This refers to the practice of staying indoors during the first postpartum month. Thus, because it was difficult to find women out of doors who met my goal expectations, I decided to include mothers as interview subjects who had older babies.

Analysis of interview content has yet to be accomplished. However, so far I have found one of the most unique cultural aspects of childbirth for Chinese women is zuo yue zi. How rigidly one practiced zuo yue zi varied depended on several factors.. Mothers practiced zuo yue zi because of the influence of things such as tradition, the presence of parents in their home, or a belief in the benefits that following the rules would bring. Rules of zuo yue zi, besides staying indoors for 30 days, include: not washing hair or brushing teeth, avoiding exposure to wind or cold, and eating certain foods (like chicken soup and eggs) and avoiding others (hot and spicy foods and cold fruit).

Currently, the spiritual aspect of childbirth as related in the interviews has yet to be analyzed. However, most of the mothers prepared for and anxiously awaited the birth of what for them was their first and only child. In several interviews they described childbirth as a bittersweet experience (xiantong huotian – Afirst bitter, then sweet@). The first two interviews were not very successful.

They did not draw out the detailed, personal experience I was looking for. Many variables could have influenced the quality of those first two interviews, including, perhaps: my inexperience with interviewing, a lack of a trusting relationship with the mothers, personality of the mothers, miscommunication, setting (one in a hospital and the other on a street), language barrier and insufficient time to follow up on result of interviews.

The remaining nine interviews were much more successful. The mothers opened up more and shared more personal details than the first two mothers. The key factor for the success of those interviews was due to the help of a local Beijing woman. She helped me find and set up eight interviews and accompanied me to those eight. She was helpful in clearing up communication problems when they arose and in establishing trusting relationships. The final nine interviews were also conducted in the mother=s home which allowed for a more personal, confidential environment.

Final analysis of interview content is expected to be carried out and finished by summer 2001. I expect to find many similarities among the women=s childbirth experiences that show how deeply their cultural and spiritual background influenced them in giving birth. From their experiences, I hope to identify specific actions nurses can take when caring for expecting Chinese women that will enable them to have the most positive experience possible during their pregnancy, childbirth, and postpartum periods.

References

• Callister, L. C., Semenic, S., & Foster, J. C. (1999). Cultural and spiritual meanings of childbirth: Orthodox Jewish and Mormon women. Journal of Holistic Nursing, 17, pp. 289- 290.
• Callister, L. C. & Vega, R. (1998). Giving birth: Guatemalan women=s voices. JOGNN, 27, pp. 289-295.
• Nichols, F. H. (1996). The meaning of the childbirth experience: Review of the literature. Journal of Perinatal Education, 5(4), 71-77.
• I’d like to acknowledge Bai Dan for her assistance in China and Tian Hong for her help with interview translations.