Socio-cultural beliefs and practices during pregnancy, child birth, and postnatal period: A qualitative study in Southern Ghana

Abstract

Despite investments in interventions to reduce maternal and neonatal morbidity and mortality, progress has been slow, especially in developing countries. Socio-cultural beliefs in communities often lead to the adoption of certain practices during pregnancy, childbirth, and postnatal period. Therefore, this study was conducted to identify these beliefs and practices and how they affect maternal and child health care services. Purposive sampling was used to select focus group discussion participants (13) among community members, pregnant women whose gestation was at least 6 months, and women with babies less than 6 months of age. In addition, 22 in-depth interviews were conducted among health workers at district, subdistrict, and community levels. All interviews were audio-recorded and transcribed verbatim. With the aid of NVivo 11, the data was analysed thematically. The study’s findings showed that socio-cultural beliefs and practices are widespread covering antenatal through childbirth to the postnatal period. Both harmful and harmless practices were identified. Protecting pregnancy from evil forces resulted in the practice of confinement and consequently late initiation of antenatal care. The use of herbal preparations to augment labour was reported and this practice favoured home delivery and use of Traditional Birth Attendant. The study concludes that socio-cultural beliefs are common and transcend the entire peripartum period. Some of these social practices tend to affect utilisation of some essential maternal and child health practices. However, accepting harmless social practices during labour will improve trust and cater for community’s worldview about childbirth and foster skilled delivery.

Keywords:

• Beliefs
• practices
• antenatal
• labour
• postnatal
• neonatal
• pregnancy
• Ghana

PUBLIC INTEREST STATEMENT

Maternal and neonatal mortality remain a serious public health concern, especially in low resource settings where healthcare facilities and services are not adequate enough to cater for maternal and neonatal cases. Besides, these settings are usually absorbed in socio-cultural beliefs and practices that have been identified to play important roles during pregnancy, childbirth, postpartum period, and care of neonates. Whereas some of these beliefs and practices may be good, others may be harmful. Knowing that these beliefs and practices may differ from community to community, this study used a qualitative research methodology to document beliefs and practices along the prenatal, antenatal, through the peripartum period. This was to ensure that good practices are identified and promoted. In contrast, harmful practices are discouraged in an attempt to reduce the burden of maternal and neonatal mortality in low resource settings, thereby propelling the country towards achieving Sustainable Development Goal 3.

Acknowledgements

The authors wish to thank all study participants for their time.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author’s contributions

JA designed the study, participated in data collection and analysis, and prepared the draft of the manuscript; EA and PBA provided scientific advice on the design of the study and data analysis. All authors read and approved the final manuscript

Data availability

Majority of the anonymised data have been included in this manuscript. Providing the individual transcripts will breech the confidentiality and anonymity requirement during ethical approval. As a result, we do not have permission from the participants to share the raw data. All interested researchers/readers/persons who meet the criteria for access to confidential data can access the data set from the corresponding author via this email address: [email protected]

Additional information

Funding

The authors solely funded this study.

Notes on contributors

Emmanuel Asampong

Dr. Joana Ansong, a Programme Officer at the WHO, Ghana Country Office is responsible for health promotion. Her research interests are in social, behavior and cultural dynamics affecting maternal, neonatal and child health as well as Non-Communicable Diseases. Her research focuses on bringing to the fore socio-cultural practices influencing intra-partum and post-partum continuum of care and how these serve as social drivers in health seeking behaviours for mothers and neonates as well as health outcomes. This current study sought to characterise the critical role of traditional birth attendants in communities and determine a more comprehensive and systematic approach of strengthening collaboration between the orthodox and non-orthodox delivery of health services especially at the community level. This project aims to reduce maternal and neonatal morbidity and mortality burden and accelerate Ghana’s quest to achieve Sustainable Development Goal 3.