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6 of 10 a dependence on self management a belief in

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6 of 10A dependence on self-management, a belief in the normality of labor and birth, and a tradition of delivery at homemight influence some women to arrive at the hospital in advanced labor. The need to travel a long distance to theclosest hospital might also be a factor contributing to arrival during late labor or to out-of-hospital delivery formany American Indian women living on rural, isolated reservations.Liberian women are reluctant to share information about pregnancy and childbirth as these subjects are taboo totalk about with others.Husbands or male elders are the ones who make decisions about allowing a woman to seek care at a clinic orhospital when she is experiencing a difficult and arduous labor. Further complicating this situation, women arereluctant to seek professional health care at clinics or hospitals because they are more comfortable in their ownhomes with traditional (but untrained) birth attendantsSupport During ChildbirthDespite the traditional emphasis on female support and guidance during labor, women from diverse culturesreport a desire to have husbands or partners present for the birth.Spouses or partners are now encouraged and even expected to make important contributions in supportingpregnant women during labor. Unfortunately, some US hospitals still enforce rules that limit the support personfrom attending the birth unless he or she has attended a formal childbirth education program.Many women also wish to have their mother or some other female relative or friend present during labor and birth.Cultural Expression of Labor PainAlthough the pain threshold is remarkably similar in all persons, regardless of gender or social, ethnic, or culturaldifferences, these differences play a definite role in a person’s perception and expression of pain. Pain is a highlypersonal experience, dependent on cultural learning, the context of the situation, and other factors unique to theindividual (Ludwig-Beymer, 2008).In the past, it was commonly believed that because women from Asian and Native American cultures were stoic,they did not feel pain in labor (Bachman, 2000). In addition to the physiologic processes involved, culturalattitudes toward the normalcy and conduct of birth, expectations of how a woman should act in labor, and the roleof significant others influence how a woman expresses and experiences labor pain.Callister and Vega (1998) reported that Guatemalan women in labor tend to vocalize their pain. Coping strategiesinclude moaning or breathing rhythmically and massaging the thighs and abdomen.Japanese, Chinese, Vietnamese, Laotian, and other women of Asian descent maintain that screaming or cryingout during labor or birth is shameful; birth is believed to be painful but something to be endured.

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