Key considerations: cultural perspectives

Incorporating cultural traditions into standard clinical practice

It is important to be aware of, to identify and to encourage cultural and religious practices to support mother-child social and emotional wellbeing because:

• The stress experienced by new mothers may be reduced by merging components of cultural practice with standard clinical practice (Down et al, 2007; Posmontier & Horowitz, 2002).
• Ethnic communities respect and appreciate collaboration that encourages recognition of the importance of cultural rituals and traditions and acknowledges the individuality of women within a cultural context (Down et al, 2007; Rice et al, 1999; Thompson, 1997).
• In order to facilitate education related to the early recognition of perinatal depression and help-seeking behaviour, it is helpful to convey your knowledge of cultural traditions. This also assists in discussing realistic expectations of motherhood and recognising the differences in New Zealand (Chan et al, 2002; Down et al, 2007; Posmontier & Horowitz, 2002; Rice et al, 1999).
• Any provision of support which enables women to share their experiences and to develop coping strategies reduces the risk of perinatal depression (Chan et al, 2002; Down et al, 2007; Thompson, 1997).

Use of Interpreters

• For effective communication, it is essential that health providers assess the women’s English language proficiency in conversation and in reading written information.
• When working with non-English or limited English speaking women, the best approach is to provide a language-matched health professional. Service users generally prefer speaking to a health professional who speaks their first language. The next best approach is to use professional interpreters to address the communication barrier between the woman and the health provider (Lim & Mortensen, 2014).
• For some cultures it is inappropriate or embarrassing for women to discuss sensitive health issues in the presence of males. Where practical, it is therefore essential to provide a female interpreter for screening or when managing sensitive issues. Additionally, the provider could use phone interpreting if face-to-face interpreting services are not available.
• Some migrant or refugee communities are small and close-knit, which can compromise confidentiality if the interpreter knows the woman or her family personally. To overcome this, the provider could use phone interpreting services which access interpreters that are not from the local community.
• The common practice of using a family member as an interpreter is problematic because the family member may not be fluent in English or translate everything said. He/she may normalise the information provided to the woman or unconsciously make decisions for her. When a woman requests that a family member interprets for her, the health provider needs to carefully consider this request. There may be a need to respectfully negotiate and to explain to the woman that the use of a skilled interpreter is essential support for the health provider to ensure effective communication and to provide assurance that the interpreter is bound by confidentiality.
• It is essential that health providers know how to work with interpreters. This can be achieved by attending the “CALD 4: Working with Interpreters” training.

Develop Trust and Rapport

See the “Additional Guidelines” section for developing trust and rapport with women and their family members.

Intergenerational and interethnic marriage issues

• Maternity care providers can be proactive in asking the pregnant women, about the need to include extended family members in her care. (This would help to identify any challenges relating to decision-making by the pregnant woman, as well as acknowledging the role of the older family members and the relationships between the woman and her extended family).
• LMCs can act as mediators by understanding, negotiating and modifying the useful cultural practices recommended by older family members with the expectant couple. (This is useful for maintaining family harmony).
• LMCs can link migrant women who are unfamiliar with the New Zealand maternity system to appropriate networks. (This is especially useful for first-time mothers and for those who have limited English language skills).

For more information about traditional beliefs and practices

See the cultural profiles section for Chinese, Indian, Korean, Filipino, Japanese, Vietnamese, Myanmarese, Muslim and Sikh groups.