Perinatal risk and the cultural ecology of health in Bihar, India

Abstract

The objective of the current study is to examine the cultural ecology of health associated with mitigating perinatal risk in Bihar, India. We describe the occurrences, objectives and explanations of health-related beliefs and behaviours during pregnancy and postpartum using focus group discussions with younger and older mothers. First, we document perceived physical and supernatural threats and the constellation of traditional and biomedical practises including taboos, superstitions and rituals used to mitigate them. Second, we describe the extent to which these practises are explained as risk-preventing versus health-promoting behaviour. Third, we discuss the extent to which these practises are consistent, inconsistent or unrelated to biomedical health practises and describe the extent to which traditional and biomedical health practises compete, conflict and coexist. Finally, we conclude with a discussion of the relationships between traditional and biomedical practises in the context of the cultural ecology of health and reflect on how a comprehensive understanding of perinatal health practises can improve the efficacy of health interventions and improve outcomes. This article is part of the theme issue ‘Ritual renaissance: new insights into the most human of behaviours’.

Ritual explained: interdisciplinary answers to Tinbergen's four questions

“…In this light, it is notable that Shaver et al [11] propose that the frequency of ritual behaviour is tied to support for mothers, which in turn is positively related to number of offspring. Legare et al [5] raise important questions about the ways a better understanding of the rituals surrounding pregnancy, birth and infant care behaviour can be harnessed to improve health outcomes for women and children. Ritual may also increase arousal and anxiety, and then to reduce it, with this cycle resulting in an increase in bonding to the group (a hypothesized adaptive function).…”

“…Chhati also serves the instrumental functions of protecting the infant from illness and attracting good fortune. Applying a scientific understanding of ritual to address problems of human social organization and change in this way has the potential to revolutionize the efficacy and impact of behavioural interventions [5].…”

“…Consider the risks associated with giving birth and having babies--these constitute recurring problems to which rituals provide psychological and cultural solutions. For these reasons, the perinatal period is heavily ritualized [5]. The Indian birth ritual called chhati, widely performed among Hindu families to initiate new babies into the family and bring good fortune, is a good example:…”

Tradition, taste and taboo: the gastroecology of maternal perinatal diet

“…Introducing biomedical beliefs and practices does not replace traditional medicine [3][4][5][6] ; instead, they coexist and jointly influence decision-making about maternal perinatal diet. 7 Thus, a comprehensive understanding of the perinatal diet requires documenting complex gastroecologies of dietary beliefs and practices. Maternal perinatal gastroecologies vary within and between populations, resulting in different beliefs about the same food or foods of the same nutritional value.…”

Cultural Variation in the Development of Beliefs About Conservation

“…Taboos of this kind are common, and in many non‐Western communities they play the same role as conservation groups in Western communities (Colding & Folke, 2001). The function of supernatural beliefs extends beyond resource conservation into other domains, such as food taboos among breast‐feeding women (Henrich & Henrich, 2010; Legare et al, 2020), and prosocial behavior and cooperation within large, unrelated groups (Norenzayan et al, 2016).…”