Reproductive health, family planning and birth rituals

Decisions about reproductive health and family planning are most likely to be made on cultural grounds. However Confucian values determine that individual needs are deferred to those of the family or society, so traditional couples may make decisions about spacing and numbers of children according to family or societal needs (e.g. the One Child policy in China). However re-settled migrants of childbearing age may make their own decisions, although parents' views will remain important.

Whilst family is generally involved in health decisions for their members, sexual matters are considered private, and either not discussed, or discreetly discussed with the respective couple. Observing confidentiality is particularly important when treating younger clients who may have consulted health professionals without the knowledge of family or parents.

Contraception

IUDs are the most common contraception used in China, with oral contraceptives being offered free of charge, and sterilisation is common. The lack of free oral contraceptives in New Zealand may pose a problem for some younger migrants.

Abortion

Beliefs stemming from religious and philosophical systems may be secondary to cultural or political norms. However, practicing Buddhists are likely to observe the principle of honouring life and would avoid abortion unless the health of the mother or baby was at risk. Confucianism and Taoism have no rules about abortion so each individual or family, according to their circumstance, would make decisions.

Pregnancy, birth, circumcision, and post-partum requirements (Much of the information in this section is taken from Tanenbaum, 2009).

There are a number of folk beliefs surrounding pregnancy, and some migrants may subscribe to any of these, even though they may not associate their belief systems with Folk Religion. Examples of these are: talking about pregnancy during first trimester, or looking inside a coffin, or digging a hole during pregnancy can bring bad luck.

Diet is very important during pregnancy and there are strict rules governing food combinations and what should be eaten before and after the birth process. The second and third trimesters are considered traditionally as yang (a hot condition) and after birth yin (a cold condition) and so foods are adjusted accordingly. Yin condition also requires keeping warm with additional coverings and clothing, not taking showers shortly after giving birth. Foods to avoid post-partum are cold drinks, salads, steamed food, green vegetables and ice cream (Tanenbaum, 2009). Family may wish to bring food for the new mothers if the hospital is not able to accommodate needs.

During the birth process there is concern about vulnerability to changes in temperature (e.g. cold winds) and they may like to keep windows closed, or air conditioning low.

In most East and Southeast Asian cultures postnatal women expect to rest for a month. Traditionally the mother may remain in hospital for five to seven days, so in the case of shorter stays in New Zealand the reason for this would need to be explained. Migrants who do not have extended family to help support them during the postnatal period may feel particularly vulnerable and need emotional support from healthcarers.

Chinese herbal medicines are often used in post-birth recovery.

Tanenbaum reports that some Asian infants develop 'Mongolian spots' which are harmless patches of bluish skin and are congenital birthmarks. They should not be mistaken for bruises.

Traditionally men are not present at the birth. Some clients may wish to take the placenta home to bury it and should be asked for their preference.

Circumcision is generally not practiced in East Asia although Wikipedia states that it is more common in Southeast Asia and is practiced in South Korea.

Astrology is important for some Asian clients, especially around pregnancy and birth. They will want to know the exact time of birth for an astrological birth chart to be prepared.

Asian clients do not generally have objection to the deceased being handled by healthcarers, so in the case of neonatal death or stillbirth the baby can be washed. It is always best to check with each family first, however.