Cultural Theories of Postpartum Bleeding in Matlab, Bangladesh: Implications for Community Health Intervention

• Published in: Journal of health, population and nutrition Vol. 27; no. 3; pp. 379 - 390
• Main Authors: Sibley, Lynn M, Hruschka, Daniel, Kalim, Nahid, Khan, Jasmin, Paul, Moni, Edmonds, Joyce K, Koblinsky, Marjorie A
• Format: Journal Article
• Language: English
• Published: Bangladesh ICDDR,B: Centre for Health and Population Research 01.06.2009; BioMed Central Ltd; BioMed Central; International Centre for Diarrhoeal Disease Research, Bangladesh
• Subjects: Adolescent; Adult; Algae; Anthropometry; Bangladesh; Bleeding; Blood; Care and treatment; Caregivers; Community health; Community health care; Community Health Services - methods; Cultural; Cultural theory; Culture; Demographic aspects; Female; Gender equality; Health Knowledge, Attitudes, Practice; Hemorrhage; Home Childbirth; Humans; Interviews as Topic; Management; Maternal health services; Maternal mortality; Middle Aged; Midwifery; Morbidity; Mortality; Original Papers; Postpartum haemorrhage; Postpartum hemorrhage; Postpartum Hemorrhage - therapy; Postpartum period; Postpartum women; Retained placenta; Risk factors; Rural Population; South Asian culture; Uterus; Women; Womens health; Young Adult; Bangladesh; Matlab Bangladesh
• ISSN: 1606-0997; 2072-1315
• DOI: 10.3329/jhpn.v27i3.3380

Early recognition can reduce maternal disability and deaths due to postpartum haemorrhage. This study identified cultural theories of postpartum bleeding that may lead to inappropriate recognition and delayed care-seeking. Qualitative and quantitative data obtained through structured interviews with 149 participants living in Matlab, Bangladesh, including women aged 18-49 years, women aged 50+ years, traditional birth attendants (TBAs), and skilled birth attendants (SBAs), were subjected to cultural domain. General consensus existed among the TBAs and lay women regarding signs, causes, and treatments of postpartum bleeding (eigenvalue ratio 5.9, mean competence 0.59, and standard deviation 0.15). Excessive bleeding appeared to be distinguished by flow characteristics, not colour or quantity. Yet, the TBAs and lay women differed significantly from the SBAs in beliefs about normalcy of blood loss, causal role of the retained placenta and malevolent spirits, and care practices critical to survival. Cultural domain analysis captures variation in theories with specificity and representativeness necessary to inform community health intervention.