Abstract

The study was undertaken to explore the influence of cultural practices on birth experiences of first-generation Nigerian women (FGNW) living in London, with the objective of highlighting factors within emic and etic care that may influence birth outcomes for this population. The study entailed an exploratory, descriptive, contextual and qualitative methodology organised in two stages.   Focus group discussions and semi-structured interviews were conducted with self-identifying FGNW with retrospective birth experiences, and eight non-Nigerian and four Nigerian midwives providing maternity care for this population. Second part entailed prospective study of FGNW at three intervals during a birth continuum. Combined epistemologies of culture care and trans-cultural theory were adopted. Thematic and ethno-nursing analytical approaches of identifying, analysing and reporting patterns and themes within the data ensued. Findings indicate that culture exerts a significant influence on birth and maternity care experiences of FGNW as care meanings are embedded in cultural values and beliefs, economics of family and other support networks, diaspora environment, culture of expectations, rituals and taboos, kinship of support, and immigration barriers in their negotiation of maternity care. Conflicts were uncovered between FGNW’s cultural and midwives professional care as aspects of FGNW’s cultural practices warrant preservation, negotiation; re-patterning to ensure continuing perinatal health and wellbeing. Culture Care Midwifery Model is espoused as a model to guide midwives in providing culturally congruent care that will meet the care needs of FGNW and optimise their health and wellbeing through birth continuum.

Key words: Birth, culture, culture care, cultural congruence, emic care, ethno-nursing theory, etic care, family, kinship.

Abbreviation

BAME, Black, Asian and Minority Ethnic group; CEMACH, Confidential Enquiry into Maternal Deaths in the UK;  CMACE, Confidential Inquiry into Maternal and Child enquiries; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, 4th Edition; Emic care, folk, traditional/cultural care; Etic care, professional care based on biomedical model of care; FGNW, first-generation Nigerian women. FGNW in the context of this study are women born in Nigeria who migrated to the United Kingdom (UK) and are domiciled in London; ‘igbu ewu ukwu’, celebration of fertility by slaughter of goats at the birth of a tenth and subsequent child/ren in Igbo culture; NICE, National Institute for Health and Care Excellence; Omugwo, specified rest period of about a month to three months of the Igbo’s of Eastern Nigeria which is symbolic and similar to the Chinese ritual of ‘doing the month’; ONS, Office of National Statistics; MBRRACE, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK); MREC, National Health Service Multi-Centre Research Ethics Committees; Mw, midwife; Wm, woman.