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Japanese Cultural Practices in Antepartum, Intrapartum, Postpartum and Newborn Care

Created By: Brandi-Nicole M. Anastacio Fall 2013 The following is a brief overview of Japanese cultural practices and beliefs regarding pregnancy, retrieved thru interviews of Japanese woman in the community and journal articles. Antepartum Prenatal care is viewed as important and instituted early. In Japan, a mother would receive a book called Maternal and Child Health Handbook. This book is used to keep recordings of prenatal care. Prenatal care provided primarily by Midwives. Doctors are usually seen only at birth, right when the head is crowing. Prenatal vitamins are not normally prescribed or recommended. If they are, they are started late in pregnancy Follows doctor/midwifes orders without question, viewed as disrespectful Woman usually discontinue work during the early second trimester, work is discouraged Woman are viewed as the sole person responsible for fetal outcome Unwed mothers are negatively viewed Fathers are not expected to participate in prenatal visits and are not viewed as influences on the fetal outcome Sex can only be performed with a condom because the penis is viewed as dirty Too much weight gain is discouraged and the woman should not gain more than 19-20 lbs Share a strong belief that negative thoughts and music can affect the fetus. Pregnancy is viewed as a hot state, so the mother is responsible in keeping the baby warm, by taking hot baths, keeping abdomen wrapped at all times with a haramaki, never allowing the hair to air dry (blow dry only) and only consuming hot foods and drinks. KCC-ADN, NURS-320, Prof. Aganon Diet consists of hot( yang) foods like fish, ginger sushi, pickled plums, miso soup, eggs and green tea. Dairy, fruits, spices and eggplants are avoided because they are considered cold (yin) foods and harmful to the fetus. In a ceremony called, chakutai or iwaiobi, during the fifth month, the mother is wrapped in a bleached cotton sash that has been blessed at a Shinto shrine. This is in the hopes of ensuring an easy delivery. During the eighth month, saetogari meaning going back home takes place and the mother returns to her parents home to be cared for prior to and up to 4-6 weeks after birth. This tradition has changed, with the mother, sister or mother-in-law coming to the new moms home. Intra-partum Alternative pain control methods including massage, breathing and movement are the interventions of choice. Epidural and other medications are not requested due to the belief that the labor pain strengthens the bond between mother and child. Labor is viewed as a goal oriented task that needs to be done well and quickly. Usually labor quietly and remain stoic Eating during labor is encouraged to ensure strength, foods like mochi and d protein rich foods Males, besides the doctor, not usually present, so father is not usually present. May ask for a portion of the umbilical cord, it is usually kept in a kotobuki bako or long life box and given to the childs future spouse.

(I no naka no kawazu taikai wo shirazu)


Literally: A frog in a well does not know the great sea. This means: People are satisfied to judge things by their own narrow experience, Never knowing of the wide world outside

Postpartum In Japan, the mother is usually in the hospital for one week for a normal vaginal delivery Breastfeeding is initiated immediately after birth with the assistance of midwives, whom provide frequent breast massage Will not seek out pain medication and will probably not display the need for it Circumcision is not done immediately after birth Mother will not shower for a month as it is viewed as bad luck Mother and baby will stay home for at least 4 weeks with the maternal grandmother Newborn Care Mothers are very attentive and take on most of the duties in caring for the newborn, the father is not expected to perform these duties, but this view is changing Babies are often carried on mothers chest or back in a carrier Co-sleeping is a norm with children sleeping with their parents even through school age Submersing the umbilical cord in hot water even before it has fallen off is not uncommon in Japan and even encouraged After one week of birth, parents often bathe with the baby Baby named in a ceremony one week after birth with family and friends presenting monetary gifts. Foods served are red rice (rice with red beans) and sea bream (white fish).

Newborn Care Discuss ways to decrease the risk of SIDS with co-sleeping Discuss cord care Community Resource Japanese Culture Center of Hawaii:

http://www.jcch.com/

Teaching Points and Nursing Interventions


Antepartum Teaching barrier: Locate a proper medical translator Educate on benefits of dietary supplements: Folic Acid and Calcium Discuss weight gain in regards to BMI Assess diet and food preparations, i.e. raw fish and green tea consumption Intrapartum Monitor pain levels and assist with alternative methods of pain relief Assess if umbilical cord will be kept Provide a quiet atmosphere and discuss with doctor the ability to continue eating, provide warm liquids Postpartum Assist with breast massage to promote breastfeeding Assess pain routinely Determine whether the mother or baby will need to return for a routine checkup and explore alternatives References Ito, M. C. (2002). Japanese womens experience of childbirth in the United States. Health Care for Women International, 23(6/7), 666-677. Kishi, R. (2011). Japanese women's experiences from pregnancy through early postpartum period. Health Care for Women International, 32(1), 57-71. Lowdermilk, D. L., Perry, S. E., & Cashion, K. (2010). Maternity nursing. (8th ed. ed.). Maryland Heights, MO: Mosby. University of Hawai'i Community College. (n.d.). Retrieved from http://www.hawcc.hawaii.edu/nursing/RN

(Deru kui wa utareru)


Literally: The stake that sticks out gets hammered down. This means: Apply your effort where it will do the most good

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