Pregnancy and delivery practices and beliefs of Ethiopian immigrant women in Israel

Abstract

This exploratory, qualitative study compared traditional and biomedical pregnancy and delivery practices from the perspective of Ethiopian immigrant women in Israel. Findings documented that certain beliefs, such as the belief that nonmedical factors (i.e., moral behavior, God, and proper nutrition) were responsible for pregnancy outcomes, were relatively unaffected by immigration. After immigration to Israel, Ethiopian women, however, chose to deliver their babies in the hospital rather than import traditional home delivery practices from their homeland. Despite many negative aspects of labor and delivery in Israel, Ethiopian immigrant women felt that it was worth enduring negative Israeli health care practices in order to have "clean," "safe," and expert deliveries. Findings from this study assist health care professionals to provide more culturally sensitive care to this immigrant group.

PIP: In order to gather information which will allow health care professionals to improve the cultural sensitivity of the care they offer to Ethiopian women immigrants in Israel, a 1991 qualitative study compared pregnancy and delivery practices in the two countries from the perspective of these women. The study sample consisted of 19 women who had migrated from Ethiopia 23-25 months previously. Six had given birth only in Ethiopia, four only in Israel, and nine in both countries. Analysis of data gained through interviews revealed that the women believed that the outcome of pregnancy and delivery depended upon proper nutrition and upon "God's will or power." Thus, the women failed to avail themselves of prenatal care. In Ethiopia, the women delivered their babies at home with the support of female family members, friends, and a traditional birth attendant. In Israel, the women delivered in a hospital alone and unsupported. In Ethiopia, the pregnant woman's modesty was considered important and was protected, but, in Israel, no regard was given to issues of modesty. In Ethiopia, the women had more control over their labor and the position in which they gave birth. In order to avoid restrictions to their activities while in labor, the women stayed at home as long as possible in Israel before rushing to the hospital. While hospital delivery was associated with loneliness, a lack of support, a lack of personal control, and invasions of privacy, these negative experiences were accepted in order to obtain the clean, safe, and "clever" care available in the hospitals. These findings indicate that culturally competent care for this group would involve respecting the need for modesty during prenatal care, increasing access to nutritional foods instead of routinely prescribing iron and vitamin supplementation, allowing a support group to accompany the woman during labor and delivery, and delaying the use of the lithotomy position and other restrictions on mobility until the last possible moment.