Health may be compromised by social interactions depending on culture among postpartum Arab and Jewish Israeli women

Abstract

Background: Social support is generally perceived to facilitate health in postpartum women; however, previous research shows that this is not always true. Social interactions intended to provide support can be perceived as negative and in turn, may have negative impacts on maternal health. The purpose of the present study was to asses if social support and negative interactions at one month after childbirth can predict maternal health four months after childbirth, and if this relationship is influenced by culture. Methods: This prospective longitudinal cohort study included randomly selected Arab (n = 203) and Jewish (n = 202) women who attended Mother and Child Health Clinics in Northern Israel one month after giving birth. The women were interviewed at one and four months after childbirth using a questionnaire including measures of health (self-reported health (SRH) and health problems), socioeconomic and demographic status, obstetric characteristics, social support, negative social interactions and perceptions of customs and traditions intended to help the mother cope after childbirth. Multivariable regressions were run to identify the variables predicting health four months after childbirth. Results: The response rate for both interviews was 90%. Negative social interactions one month after childbirth significantly predicted health problems in Arab and Jewish women (Beta 0.20 and 0.37 respectively) and SRH among Arab women only (odds ratio (OR) 0.32, confidence interval (CI) 0.19-0.54) four months after childbirth. Social support at one month after childbirth significantly predicted better SRH in both Jewish and Arab women four months after childbirth (OR 2.33, CI 1.38-3.93 and 1.59, CI 1.01-2.46 respectively) and fewer health problems only among Jewish women (Beta − 0.37). Conclusions: Social support and negative social interactions appear to be predictive of health in postpartum women. Associations varied between Arabs and Jews, indicating that social support may be more important for predicting health among Jewish women and negative interactions may be more important among Arab women. Healthcare practitioners should be aware of the cultural context and social circumstances of postpartum women to ensure they receive the social support and care they need.

“My problem is that I live next door to my mother‐in‐law”: Arab women's postpartum experiences with positive and negative social interactions and the impact on their well‐being: A qualitative study

“…Several studies exploring the potential negative effects of postpartum rituals provide support for these findings (Abudabbeh, 1998;Chien et al, 2006;Lincoln & Chae, 2012;Puddister et al, 2020).…”

“…Other studies concur that a woman's relationship with her mother-in-law can have a major impact on postpartum health, affect mental and physical health, and even induce marital conflict (Ginja et al, 2018;Green et al, 2006;Heh et al, 2004). Puddister et al (2020) found that negative interactions predict health problems in postpartum women. In the current study, women often experienced physical aches as well as feelings of anger and stress brought on by constant customary visits that failed to achieve their well-intentioned goal.…”

“…Several studies exploring the potential negative effects of postpartum rituals provide support for these findings (Abudabbeh, 1998; Chien et al., 2006; Lincoln & Chae, 2012; Puddister et al., 2020). Postpartum social interactions appear to be a double‐edged sword, providing much needed practical support but also constituting a source of interpersonal conflict, particularly when the mother‐in‐law is the care giver.…”

“…Studies on postpartum Arab women in Israel (Glasser et al, 2012;Grigoriadis et al, 2009;Puddister et al, 2020) call for understanding the factors affecting their lives to develop appropriate prevention and intervention programmes to treat and prevent PPD in Arab-Israeli women. More research is needed to understand women who may not have PPD but are still struggling with role transitions.…”

Evidence for cultural differences in affect during mother–infant interactions

“…Thus, this specific investigation represents a cultural comparison that goes beyond the common east vs. west or WEIRD vs. non-WEIRD studies, which can shed light on additional sources of cultural differences and similarities in affect. A few cross-cultural studies that include Palestinian-Arab mothers were conducted in Israel, in which the population comprises a relatively individualistic Jewish society (74.4%) and a more collectivistic Palestinian-Arab society (20.9%) 97 . It was demonstrated that Palestinian-Arab parents better adapt to work following the first childbirth compared to Jewish parents, as infants were cared for by a family member 98 .…”