Finding a ‘safe’ place on the risk continuum: a case study of pregnancy and birthing in Lao PDR

Childbirth traditions and cultural perceptions of safety in Nepal: Critical spaces to ensure the survival of mothers and newborns in remote mountain villages

“…Heath's (2007) concept of collaborative dialogue enabled local voices to be foremost while recognising the diverse factors impacting on women's safety and risk during pregnancy and childbirth. Participants' experiences were deemed authentic sources of knowledge (Popay and Williams, 1996;2006), pregnancy and childbirth experiences were viewed as naturally occurring interactions (Mead, 1972;Lincoln and Guba, 1985;Charon and Hall, 2004) and the researcher's reflexivity was sustained throughout (Maanen, 1988;Hammersley and Atkinson, 1989;Reed-Danahay, 1997).…”

“…Medically, this seclusion of women in the cowshed during and after birth is considered as creating risks of infection leading to higher mortality (Thapa et al, 2001). Contrastingly, researchers have argued that women should not be separated from their cultural settings during pregnancy and childbirth (Brubaker and Dillaway, 2009;Cindoglu and Sayan-Cengiz, 2010;Kontos, 2011;Lee et al, 2012;Hall et al, 2012) and tradition should be embedded within medical care (Eckermann, 2006;Rice et al, 1994). Women in rural Nepal prefer to birth in their community setting to maintain their cultural safety (Thapa et al, 2001;Bennett et al, 2008) and women in diverse societies act differently to enhance childbirth safety (Miller and Shriver, 2012).…”

“…Nevertheless, research in Lao and Australia demonstrates that it is possible for medicine and culture/tradition to cooperate to provide experiences and outcomes for women which are both medically and culturally safer (Eckermann, 2006, Rice et al, 1994. In Lao, the practice of traditional initiation for the baby and the recovery of mother immediately after birth by spiritual healers are allowed to be performed in hospital and have contributed to managing medical risks and maintaining cultural safety (Eckermann, 2006). Similarly, one Australian hospital now accommodates migrant women's desires to continue their tradition of the soul calling ceremony in the operating theatre, without which they demonstrate inconsolable postnatal depression (Rice et al, 1994).…”

Quality of Life for Pregnant and Recent Parity Women in Lao PDR

“…Attaran (2005, p. 959) observes that directly measuring MMR in the whole population is not today an option. Eckermann (2006aEckermann ( , b, 2008) also comments on the unreliability of actual maternal and infant deaths statistics in the Lao PDR. She states 'As in most developing countries, official statistics are likely to represent only the tip of the iceberg as many parts of the country are too remote for data on maternal and infant deaths to be systematically gathered and reported ' (2008, p. 767).…”

“…The qualitative methods employed by Eckermann (2006aEckermann ( , b, c, 2008, and Eck- Eckemann's frequent and extensive field visits to sites hosting a MWH in each of the 17 Districts in the Attapeu, Saravan and Sekong Provinces in Southern Lao PDR provide an insight into how villagers perceive the services offered and explanations for why uptake of the MWH facilities remains relatively low. She identified that in all three provinces the majority of women and men said they would use a MWH but with some important qualifications.…”