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Item type Presentation
Format Text-based Document
Title Teaching Students and Nurses Evidence-BasedRecommendations for Culturally Sensitive Perinatal Careof Somali Immigrant Women
Authors Missal, Bernita Eileen; Clark, Connie Lynn
Downloaded 6-May-2018 11:35:10
Link to item http://hdl.handle.net/10755/603774
Teaching Students and Nurses Evidence-based Recommendations of Culturally Sensitive Perinatal Care for
Somali Immigrant Women
Bernita Missal, PhD, RNConnie Clark. PhD, RNBethel University
Objectives:
1. The learner will be able to examine the evidence related to culturally sensitive care for Somali immigrant new mothers.
2. The learner will be able to integrate recommendations for culturally sensitive care for Somali immigrant new mothers into nursing and patient education.
Somalia: History
• 1960: Somalia becomes independent from Britain andItaly.
• 1969: Dictatorial socialist state with persecution, torture, and jailing of opponents.
• 1991: Regime overthrown. Clan warfare.
Central government and infrastructure destroyed.Metz, 1993; CIA The World Factbook, 2013; Encyclopedia Britannica, 2013.
CIA The World Factbook. (n.d.). Retrieved from https://www.cia.gov/library/publications/the-world-
factbook/geos/so.html
Somalia: Refugees & Diaspora• Est. 300,000 Somalis died during the war
• Over 1 million refugees
• Somalia - 3rd largest number of of refugees in the world
(UNHCR, 2013).
Al Jazeera.. (2013). Retrieved from http://stream.aljazeera.com/story/somalias-global-diaspora-0022000
(United Nations (UN], n.d.)
(United Nations High Commissioner for Refugees [UNHCR], 2013).
Harrison, J. Oxfam International Blog.. (2011). Retrieved from http://blogs.oxfam.org/en/blog/11-07-26-dadaab-diary-fleeing-famine
CNN. (2009). Retrieved from http://www.cnn.com/2009/WORLD/africa/09/03/somalia.refugee.conditions/
“Discover, document, know, and explain the interdependence of care and culture phenomena with differences and similarities between and among cultures” (Leininger & McFarland, 2006, p.4).
Cultural Care Diversity & Universality Theory
University of Washington School of Nursing. (2012). Retrieved from
http://nursing.uw.edu/newsroom/press-releases/remembering-madeleine-
leininger-leader-in-transcultural-nursing-and-former-d
Purpose of Study
Minnesota Public Radio. (2011). Retrieved from http://minnesota.publicradio.org/display/web/2009/02/26/mosque_openhouse
To explore Somali immigrant new mothers’ experience of childbirth in Minnesota
Design
• Qualitative research • Twelve female participants• In-depth individual interviews• Semi-structured open-ended
questions
BBC. (2013) . Retrieved from http://www.bbc.co.uk/news/world-africa-20033839
Data Collection
• Collaborated with Somali women community leaders • Snowball sampling technique• Interviews at varied locations
Minnesota Historical Society. (2004). Retrieved from http://education.mnhs.org/immigration/narrators/somali/abdisalam-
adam/raising-children-in-somalia
Evidence for Culturally Sensitive Care to Somali Immigrant New Mothers
1) Family’s & friends’ support2) Cultural & religious practices3) Relationships with nurses4) Views on Cesarean section5) Postpartum blues/depression
USA_Mania-Job-Recruitment Ads. (n.d.). Retrieved from http://usamania.wikispaces.com/Job+-+Recruitment+Ads
• Loss of mother’s help & advice• Loss of traditional family support
Family
Retrieved from madaale.com
“Don’t have a family here.
Think about family and get sad.”
Husband’s Support
“Culturally, boys don’t cook. He washed, cleaned the house, vacuumed.”
Different from Somalia: • Husband’s presence in
the delivery room.• Husband’s extensive help
with household tasks.
Salon. (2002). Retrieved from http://www.salon.com/2002/09/05/jama/
• Any available family member or friend helped.
Extended Family and Friends’ Support
Minnesota Historical Society. (2004). Retrieved from http://education.mnhs.org/immigration/narrators/somali/hared-mah/many-somalis-came-from-other-
states-because-there-were-jobs-available-her
“Sister-in-law lived with me for two years”.
“If you are Somali, you are friends.”
Cultural & Religious Practices
• Traditional foods• 40-day postpartum
period• Prayer at the time
of birth
Somaliweyn. (2009). Retrieved from http://www.somaliweyn.org/pages/news/Oct_09/23Oct24.html
• Food brought by family & friends to the hospital: oatmeal & tea – for breast milk.
• Traditionally Somali women eat during labor.
Traditional Foods
“‘No, I am going to eat hospital food’, and she
[friend] was like: ‘No, you are a new mother and you are
going to get hungry in the middle of the night.’ “And
4:00 in the morning came and I was so hungry and I had my
porridge and I was so grateful.” The Phoenix of Somalia. (n.d.). Retrieved from
http://thephoenixofsomalia.wordpress.com/2011/03/13/somali-spiced-tea/
“‘She has no energy, how is she supposed to push the baby?’ My mom was really angry.”
In Somalia:• Mother stays at home and only cares for the baby• Female relatives do all household work
At the end of 40 days: • Special celebration with the extended family & friends• Special food and clothes
40-day Postpartum Period
“All that she does is feed the baby and sleep, that’s it.”
“In America nobody gets that time. When we got out, we went to Target. That is very strange.”
• Father whispers prayer in baby’s ear
Prayer at Birth
“Prayer for help, for the mother and baby to
have a happy face.”
Relationships with Nurses
Superscholar. (n.d.). Retrieved from http://www.superscholar.org/top-nursing-jobs-degrees/
• Physical care• Emotional support• Teaching “One nurse was the
best. She was coming to visit me often. She taught me about the
baby and to care for the baby. She was nice. She
was talkative.”
Views on Cesarean Section
Aversion towards C/S
Avoid going to the hospital
Family strongly disapproves Commercial interest of
physicians
Punishment
Why is it necessary?
• Not common in Somalia• Viewed as a weakness
Postpartum Blues/Depression
“You’re by yourself, you’re so tired. You don’t get to rest. My sister had a
different experience because her mother-in-law always cooked. The
food was not there [for me], that was a big challenge.”
[Husband says] “What are you doing? My mom had 12 kids, never cried. You’re weak.”
Recommendations for Staff Nurses
Retrieved from http://www.preemiesinapod.com
/who-is-your-primary-nurse/
Husband Ask woman about his companionship during labor & delivery.Include husband in pre- and postnatal teaching.
Family & Friends Ask woman about preferred guests.Monitor traffic in the room.
Cultural Aspects Be aware of loss of social support & 40-day period. Permit food.
Postpartum Depression/Blues
Be aware of its prevalence, denial, and stigma. Educate.
Build Trusting Relationships
Share personal experiences with children; allow time for questions, give rationale
Recommendation for Nurse Educators
• Teach students to be sensitive to the challenges of being in a second culture
• Teach students about importance of cultural and religious practices
• Teach importance of establishing trusting relationships
• Teach use of community resources
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