Maternal Health in Timor-Leste: Representations and Practices during Pregnancy, Birth and the Postnatal Period

H. B. Manuel, N. Ramos

Abstract


Culture has a strong influence on the representations and health behaviour of individuals and groups. This is reflected in the reproductive health of the Timorese women, intervention in this field being of a priority nature in Timor-Leste in view of its high fertility and maternal mortality rates. The purpose of this ethnographic study is to analyse beliefs, representations and practices associated with pregnancy, birth and the postnatal period. It was conducted in Timor-Leste and involved the participation of health professionals, traditional midwives, women and couples, all of them selected through a snowball chain sampling procedure. Data was collected by means of exploratory semi-structured interviews and observation, and its content was duly analysed. The results show the existence of various recommendations, taboos and restrictions which aim at protecting the health of both mother and child, making use of traditional care practices which may vary among ethnolinguistic groups, communities or families.

 


Keywords


Behaviour; culture; development; maternal health; Timor-Leste

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References


Anderson, S. V., & Bauwens, Eleanor E. (1982). An ethnography of home birth. In M. A. Kay (Ed.), Anthropology of human birth (pp. 289-303). Philadelphia: F. A. Davis.

Baião, M. R., & Deslandes, S. F. (2006). Alimentação na gravidez e puerpério [Diet during pregnancy and the postnatal period]. Revista de Nutrição, 19(2), 245-25. Available at: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1415-52732006000200011.

Bartoli, L. (1998). Venir au monde: Les rites de l'enfantement sur les cinq continents [Coming into this world: The rites of childbirth in the five continents]. Paris: Plon.

Beers, S-J. (2001). Jamu: The ancient indonesian art of herbal healing. Singapore: Periplus.

Berry, J. W., Dasen, P. R., & Saraswathi, T. S. (Eds.) (1987). Handbook of cross cultural psychology. Vol. II: Basic processes and human development. Boston, Massachusetts: Allyn and Bacon.

Brisbois, E., & Douvier, F. (1980). Les Toradja de Célèbes (Indonésie). [The Toradja of the Celebes (Indonesia)] Paris: Hachette.

Carmo, A. D. A. (1965). O povo Mambai: Contribuição para o estudo do grupo linguístico Mambai – Timor [The Mambai people: Contribution to the study on the Mambai linguistic group]. Estudos Políticos e Sociais, Lisbon, 3(4), 1233-1368.

Cavendish, R. (Ed.) (1970). Man, myth & magic: An illustrated encyclopedia of the supernatural, vol. 12. New York: Marshall Cavendish Corporation.

Cole, M. (1998). Cultural psychology: A once and future discipline. Cambridge, Massachusetts: Harvard University Press.

Corrêa, A. P. (1935). Gentio de Timôr [People from Timor]. Lisbon: Author’s Edition.

Coughlin, R. J. (1965). Pregnancy and birth in Vietnam. In D. V. Hart, P. A. Rajadhon, & R. J. Coughlin (Eds.), Southeast Asian birth customs: Three studies in human reproduction (pp. 205-273). New Haven, Connecticut: Human Relations Area Files Press.

Duarte, J. B. (1984). Timor - ritos e mitos ataúros [Timor – rituals and myths of the Ataúros]. Lisbon: Instituto de Cultura e Língua Portuguesa.

Dundes, L. (2003). The evolution of maternal birthing position. In L. Dundes (Ed.), The manner born: Birth rites in cross-cultural perspective (pp. 53-63). Walnut Creek, California: Altamira Press.

Friedberg, C. (1982). Muk gubul nor “La chevelure de la terre”: Les Bunaq de Timor et les plantes [Muk gubul nor “The hair of the earth”: The Bunaq of Timor and plants]. (Unpublished doctoral thesis). Université Paris V – René Descartes, France, 5 vols.

Gélis, J. (1984). L'arbre et le fruit: La naissance dans l'occident moderne (XVIe-XIXe siècle) [The tree and the fruit: Childbirth in modern occident (16th-19th century)]. Paris: Fayard.

Gomes, F. A. (1972). Os Fataluku [The Fatalukus]. (Unpublished master's thesis). Instituto Superior de Ciências Sociais e Política Ultramarina (ISCSPU), Universidade Técnica de Lisboa, Portugal.

Government of the Democratic Republic of Timor-Leste & United Nations Development Programme [UNDP] (2009). The Millennium Development Goals, Timor-Leste. Dili: Government of the Democratic Republic of Timor-Leste & UNDP.

Grace, J. (1996). Healers and modern health services: Antenatal, birthing and postpartum care in rural East Lombok, Indonesia. In P. L. Rice & L. Manderson (Eds.), Maternity and reproductive health in Asian societies (pp. 145-167). Amsterdam: Harwood Academic Publishers.

Hanks, J. (1963). Maternity and its rituals in Bang Chan. Cornell Thailand Project Interim Reports Series 6. Ithaca, New York: Department of Asian Studies, Cornell University.

Hart, D. V. (1965). From pregnancy through birth in a Bisayan Filipino village. In D. V. Hart, P.A. Rajadhon, & R. J. Coughlin (Eds.), Southeast Asian birth customs: Three studies in human reproduction (pp. 1-113). New Haven, Connecticut: Human Relations Area Files Press.

Health Alliance International [HAI] (2004). Strengthening maternal and newborn care in Timor Leste: Focus group discussions with midwives – Aileu, Ermera, Liquisa and Manatuto districts. (Unpublished report). Dili: HAI.

Health Alliance International [HAI] (2005). Strengthening maternal and newborn care in Timor Leste: Qualitative community assessment Aileu and Manatuto districts. (Unpublished report). Dili: HAI.

Health Alliance International (HAI) [2008]. Improving maternal and newborn health in Timor-Leste. Birth-friendly facilities program: An implementation evaluation report for Health Alliance International. (Unpublished report). Dili: HAI.

Helman, C. G. (1990). Culture, health and illness (2nd ed.). Oxford: Butterworth-Heinemann.

Hicks, D. (1976). Tetum ghosts and kin: Fieldwork in an Indonesian community. Palo Alto, California: Mayfield.

Hunter, C. L. (2002). Embracing modernity: transformations in Sasak confinement practices. In S. Rosario & G. Samuel (Eds.), The daughters of Hariti: Childbirth and female healers in South and Southeast Asia (pp. 279-297). London: Routledge.

Jirojwong, S. (1996). Health beliefs and the use of antenatal care among pregnant women in Southern Thailand. In P. L. Rice & L. Manderson (Eds.), Maternity and reproductive health in Asian societies (pp. 61-82). Amsterdam: Harwood Academic Publishers.

Kitzinger, S. (1992). Ourselves as mothers. London: Doubleday.

Laderman, C. (1982). Giving birth in a Malay village. In M. A. Kay (Ed.), Anthropology of human birth (pp. 81-100). Philadelphia: F. A. Davis.

Laderman, C. (1983). Wives and midwives: Childbirth and nutrition in rural Malaysia. Berkeley, California: University of California Press.

Lefèber, Y. (1994). Midwives without training: Practices and beliefs of traditional birth attendants in Africa, Asia and Latin America. Assen: Van Gorcum.

Manderson, L. (2003). Roasting, smoking, and dieting in response to birth. In L. Dundes (Ed.), The manner born: Birth rites in cross-cultural perspective (pp. 137-160). Walnut Creek, California: AltaMira Press.

Martinho, J. (1943). Timor: Quatro séculos de colonização portuguesa [Timor: Four centuries of Portuguese colonisation]. Oporto: Livraria Progredior.

McDonald, S., & Middleton, P. (2009). Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes (Review). Cochrane Database of Systematic Reviews, 1. JohnWiley & Sons, Ltd. Available at: http://apps.who.int/rhl/reviews/CD004074.pdf.

McWilliam, A. (1998). Rituals of birth. In J. J. Fox (Ed.), Indonesian heritage: Religion and ritual (pp. 112-113). Singapore: Archipelago Press.

McWilliam, A. (2002). Paths of origin, gates of life: A study of place and precedence in Southwest Timor. Leiden: KITLV Press.

Ministry of Health Timor-Leste (2004). National Family Planning Policy. Dili: Ministry of Health and UNFPA.

Ministry of Health Timor-Leste (2008). Health Sector Strategic Plan 2008-2012. Dili: Ministry of Health.

Ministry of Health Timor-Leste, United Nations Population Fund (UNFPA), & World Health Organization [WHO] (2004). National Reproductive Health Strategy 2004-2015. Dili: Ministry of Health.

National Statistics Directorate [NSD], Ministry of Finance Timor-Leste, & ICF Macro (2010). Timor-Leste Demographic and Health Survey 2009-10. Dili: NSD & ICF Macro.

Nourse, J. (1999). Conceiving spirits: Birth rituals and contested identities among Laujé of Indonesia. Washington, D. C.: Smithsonian Institution Press.

Nydegger, W., & Nydegger, C. (1963). Tarong: An Ilocos barrio in the Philippines. In B. B. Whiting (Ed.), Six cultures: Studies on child rearing (pp. 693-867). New York: John Wiley & Sons.

Poulsen, A. (2007). Childbirth and tradition in Northeast Thailand: Forty years of development and cultural change. Copenhagen: NIAS Press.

Priya, J. V. (1992). Birth traditions & modern pregnancy care. Dorset: Element.

Rajadhon, P. A. (1965). From pregnancy through birth in a Bisayan Filipino village. In D. V. Hart, P. A. Rajadhon, & R. J. Coughlin (Eds.), Southeast Asian birth customs: Three studies in human reproduction (pp. 115-204). New Haven, Connecticut: Human Relations Area Files Press.

Ramos, N. (2004). Psicologia clínica e da saúde [Clinical and health psychology]. Lisbon: Universidade Aberta.

Ramos, N. (2012). Comunicação em saúde e interculturalidade – Perspectivas teóricas, metodológicas e práticas [Health communication and interculturality – theoretical, methodological and practical perspectives]. RECIIS – Revista Eletrónica de Comunicação, Informação e Inovação em Saúde, 6(4). Available at: https://repositorioaberto.uab.pt/handle/10400.2/3148

Renard-Clamagirand, B. (1982). Marobo: Une société ema de Timor [Marobo: An ema society of Timor]. Paris: SELAF.

Sims, A. (1991). Myth and metaphor in Ketengban pregnancy and childbirth practices. Irian, Bulletin of West Irian Development, XIX, 91-106.

Super, C. M., & Harkness, S. (1986). The developmental niche: a conceptualization at the interface of child and culture. International Journal of Behavioral Development, 9, 545-569.

Symonds, P. V. (1996). Journey to thelLand of light: Birth among Hmong women. In P. L. Rice & L. Manderson (Eds.), Maternity and reproductive health in Asian societies (pp. 103-123). Amsterdam: Harwood Academic Publishers.

Teljeur, D. (1994). Life-cycle rituals among the Gimán of South Halmahera. In L. Visser (Ed.), Halmahera and beyond: Social science research in the Moluccas (pp. 165-194). Leiden: KITLV Press.

Therik, T. (2004). Wehali: The female land. Traditions of a Timorese ritual centre. Canberra: Pandanus Books and Research School of Pacific and Asian Studies (RSPAS).

Thomas, B. (2005). Childbearing in Timor-Leste: Beliefs, practices and issues. (Unpublished master's thesis). Massey University, Palmerston North, New Zealand.

Townsend, K., & Rice, P. L. (1996). A baby is born in site 2 camp: Pregnancy, birth and confinement among Cambodian refugee women. In P. L. Rice & L. Manderson (Eds.), Maternity and reproductive health in Asian societies (pp. 125-143). Amsterdam: Harwood Academic Publishers.

Valsiner, J. (1989). Human development and culture. Lexington, Massachusetts: D. C. Heath & Co.

Van Schoor, V. (2003). Sitting fire: A community-based study of home births and postpartum care in East Timor. (Unpublished master's thesis). University of Amsterdam, Netherlands.

Vincent-Priya, J. (1991). Birth without doctors: Conversations with traditional midwives. London: Earthscan Publications.

Yancey, M. (2002). Abnormal presentations. In F. W. Ling & P. Duff (Eds.), Pocket guide for obstetrics & gynecology: Principles for practice (pp. 298-328). New York: McGraw-Hill.

Whittaker, A. (1996). White blood and falling wombs: Ethnogynaecology in Northeast Thailand. In P. L. Rice & L. Manderson (Eds.), Maternity and reproductive health in Asian societies (pp. 207-225). Amsterdam: Harwood Academic Publishers.

Whittaker, A. (2002). The demise of birth attendants in Northeast Thailand: embodying tradition in modern times. In S. Rozario & G. Samuel (Eds.), The daughters of Hariti: Childbirth and female healers in South and Southeast Asia (pp. 211-233). London: Routledge.

Wiart, C. (2000). Medicinal plants of Southeast Asia. Subang Jaya: Pelanduk Publications.

Wild, K. (2009). Maternity waiting homes and the shaping of maternal health policy in Timor-Leste. (Unpublished Ph.D. thesis). Charles Darwin University, Australia. Available at: http://wren.cdu.edu.au/eserv/cdu:9272/Thesis_CDU_9272_Wild_K.pdf.

World Health Organization [WHO] (2006). Pregnancy, childbirth, postpartum and newborn care: A guide for essential practice. (2nd ed.) Geneva: WHO.




DOI: https://doi.org/10.5195/hcs.2017.231

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