Cultural aspects in the care of the orthodox Jewish woman

This article offers an overview and explanation of some of the main customs and laws in the Jewish religion surrounding the reproductive health care of the Torah-observant woman. By understanding the religious and spiritual needs and preferences of a patient, the midwife is better able to provide optimal, culturally-competent care. Some of the aspects discussed include procreation, menstruation, modesty, contraception, abortion, genetic testing, induction, the Sabbath, Kosher diet, circumcision, and naming of the child.     

NURSE-MIDWIVES AND OBSTETRICIANS: A TEAM APPROACH IN PRIVATE PRACTICE REVISITED: A 5-Year Report

This study reports a 5-year experience in a private practice team approach to obstetrical care. Two nurse-midwives during the 5-year study period delivered 66% of those clients who delivered vaginally. All normal clients had a choice of their birth attendant (nurse-midwife or obstetrician). Low birth weight infants (≤2500 g) and perinatal deaths decreased each year of the study except year 4. Family-centered maternity care and formal childbirth preparation were introduced into the practice and community. Each year noted an increase in the number of participants. Clients, their families, nurse-midwives, and obstetricians expressed satisfaction with this approach to childbearing.     

TRANSCULTURAL MIDWIFERY: Adapting to Hmong Birthing Customs in California

Nurse-midwifery care can adapt to incorporate birth customs and practices of immigrant groups seeking childbirth care. This paper explores birthing traditions among the Hmong, Laotian people. Fifteen Hmong men and women immigrants to Isla Vista, California were interviewed. The information gathered revealed the need to maintain traditional Hmong customs to facilitate both physical and emotional well-being during childbirth in the United States. Birthing and dietary traditions can be adapted within the hospital setting, if the nurse-midwife is aware of the need.     

Giving birth: the voices of Orthodox Jewish women living in Canada

OBJECTIVE: To describe the meaning of the childbirth experience to Orthodox Jewish women living in Canada. DESIGN: In this phenomenologic study, audiotaped interviews were conducted. Tapes were transcribed verbatim and analyzed for emergent themes. Demographic data also were collected. SETTING AND PARTICIPANTS: Thirty Orthodox Jewish women who had given birth to healthy full-term newborns at a university-affiliated Jewish hospital in Montreal, Canada, participated in the study. Data were collected within 2 weeks after childbirth, either in the mother's postpartum hospital room or in her home. RESULTS: The following themes reflecting spiritual/cultural dimensions of the childbirth experience were identified: (a) birth as a significant life event, (b) birth as a bittersweet paradox, (c) the spiritual dimensions of giving birth, (d) the importance of obedience to rabbinical law, and (e) a sense of support and affirmation. CONCLUSION: This study documents cultural, religious, and spiritual dimensions of the childbirth experience of Orthodox Jewish women living in Canada. Knowledge and appreciation of the multiple dimensions of childbirth reflected by this study's findings can contribute to holistic and culturally competent nursing care of women and newborns.     

Contraceptive counseling for orthodox Jewish women.

OBJECTIVES: The evaluation of birth control issues among orthodox Jews who strictly follow the Halachah (the Jewish codes of conduct). METHODS: We examine traditional Jewish concepts and practices of reproduction, review various contraceptive methods, and define problems that may arise with their use in the Jewish orthodox society. We focus on the orthodox and ultra-orthodox (Haredi) elements of the Jewish community. RESULTS: The choices of orthodox religious women are limited and determined largely by considerations related to religious doctrine. CONCLUSIONS: Understanding the religious, social and cultural background of patients, religious orthodox women in particular, enables to appropriately counsel them.     

ASTHMA: A Comprehensive Review

Asthma is common among women of childbearing and childrearing age. As a primary health care provider, the certified nurse-midwife is often called upon to play a direct role in diagnosis and collaborative co-management. This article reviews the pathogenesis of asthma and its natural history during pregnancy. Patient symptoms and findings on physical examination are described in depth, enabling clinicians to detect subtle presentations and avoid common pitfalls. A section on pulmonary function tests and other laboratory tools provides a foundation for objective monitoring of pulmonary function. Environmental control measures and pharmacologic therapies are described in detail. An algorithm for treatment strategies allows certified nurse-midwives to play an active role in co-management of their asthmatic patients, while a section on patient education highlights the essential teaching points her clients will require. Specific issues regarding antenatal fetal well-being and intrapartal management are discussed. With a sound knowledge base, and through their expertise in client education and counseling, the certified nurse-midwife is in a special position to optimize care for women with asthma.     

Asthma A comprehensive review

Asthma is common among women of childbearing and childrearing age. As a primary health care provider, the certified nurse-midwife is often called upon to play a direct role in diagnosis and collaborative co-management. This article reviews the pathogenesis of asthma and its natural history during pregnancy. Patient symptoms and findings on physical examination are described in depth, enabling clinicians to detect subtle presentations and avoid common pitfalls. A section on pulmonary function tests and other laboratory tools provides a foundationn for objective monitoring of pulmonary function. Environmental control measures and pharmacologic therapies are described in detail. An algorithm for treatment strategies allows certified nurse-midwives to play an active role in co-management of their asthmatic patients, while a section on patient education highlights the essential teaching points her clients will require. Specific issues regarding antenatal fetal well-being and intrapartal management are discussed. With a sound knowledge base, and through their expertise in client education and counseling, the certified nurse-midwife is in a special position to optimize care for women with asthma.     

Expectation and Experience in Alternative and Conventional Birth

A study was conducted to determine if differences exist between the clients of two types of health-care services with regard to the childbirth experience. Nurse-midwife-attended and physician-attended births were compared in terms of the birthing woman's expected and actual participation in her own birthing experience. Questionnaires were completed before and after delivery. The nurse-midwife group both anticipated and experienced significantly more active participation in the birth than the physician group. Also, women attended by nurse-midwives viewed themselves and their partners as the most important individuals for contributing to the satisfaction of the experience while women attended by physicians more often viewed the infant as most important. Differences between the study groups were also found regarding the perceived importance of the birth attendant and the staff nurse.     

Contraceptive counseling for orthodox Jewish women

Objectives The evaluation of birth control issues among orthodox Jews who strictly follow the Halachah (the Jewish codes of conduct).

Methods We examine traditional Jewish concepts and practices of reproduction, review various contraceptive methods, and define problems that may arise with their use in the Jewish orthodox society. We focus on the orthodox and ultra-orthodox (Haredi) elements of the Jewish community.

Results The choices of orthodox religious women are limited and determined largely by considerations related to religious doctrine.

Conclusions Understanding the religious, social and cultural background of patients, religious orthodox women in particular, enables to appropriately counsel them.     

Nyo dua hli--30 days confinement: traditions and changed childbearing beliefs and practices among Hmong women in Australia

OBJECTIVE: To examine traditional and changed beliefs and practices related to the puerperium of Hmong women in Melbourne, Australia. DESIGN: An ethnographic study of reproductive health among Hmong women in Australia. SETTING: Melbourne Metropolitan Area, Victoria, Australia. PARTICIPANTS: 27 Hmong women, three shamans, two medicine women and one magic healer who are now living in Melbourne. FINDINGS: In the Hmong tradition, the first 30 days after birth is seen as the most dangerous period for a new mother. There are several beliefs and practices which women must observe in order to regain strength and avoid poor health in the future. Lying near the fire in the first three days is one such belief. The woman's body during the puerperium is considered polluted. Hence, there are several rules to restrict the woman and the substance of her body. It appears the Hmong continue to observe their post-birth confinement practices regardless of their new environment. Most women mentioned that this is to avoid ill health and misfortune in the future. There are only a few customs which they have to modify due to changes in their living situations in a new country. IMPLICATIONS FOR PRACTICE: Hmong cultural beliefs and practices concerning the puerperium in particular, and childbearing in general, have specific implications for midwifery care. Since midwives will continue to encounter many traditional beliefs and practices of the Hmong when providing birthing care to Hmong women, it is essential that their cultural beliefs and practices be taken into account. This will not only help to avoid misunderstanding, but also result in culturally appropriate and sensitive care for immigrant women.     

The beginning of human life

INTRODUCTION: The Jewish religion is characterized by a strict association between faith and practical precept. Jewish law has two sections, the written and the oral tradition. The foundation of the written law and the origin of authority is the Torah, the first five books of the Scripture. It is an expression of God's revelation, teaching and guiding humanity. The oral laws interpret, expand, and elucidate the written Torah and behavior patterns regulate new rules and customs. The main parts of the oral law are as follows: the Mishnah, the Talmud, Post-Talmudic Codes and. Responsa Literature. DISCUSSION: Life is a process that has a beginning and an end. The consensus about the time when human life really begins is still not reached among scientists, philosophers, ethicists, sociologists and theologizes. The scientific data suggested that a single developmental moment marking the beginning of human life does not exist. Current biological perspectives on when human life begins range through fertilization, gastrulation, to birth and even after. The development of a newborn is a smoothly continuous process. RESULTS: Procreation is acknowledged in the Bible to be the gift of God. The (Halachic) Jewish interpretation of when human life begins is extracted predominantly from procreation is acknowledged in the Bible to be the gift of God. The Jewish interpretation of when human life begins is extracted predominantly from The Halachic sources. The Bible does not make any other direct references regarding the beginning of human life. CONCLUSION: While the Talmud gives the full status of humanness to a child at birth, the rabbinical writings have partially extended the acquisition of humanness to the 13th postnatal day of life for full-term infants. The Babylonian Talmud Yevamot 69b states that: "the embryo is considered to be mere water until the fortieth day." Afterwards, it is considered subhuman until it is born. The issues of abortion, embryo research, multifetal reduction and cloning will be discussed according to Jewish Law perspectives. Life is a process that has a beginning and an end. The consensus about the time when human life really begins is still not reached among scientists, philosophers, ethicists, sociologists and theologizes. The scientific data suggested that a single developmental moment marking the beginning of human life does not exist. Current biological perspectives on when human life begins range through fertilization, gastrulation, to birth and even after. The development of a newborn is a smoothly continuous process.     

Parental religious affiliation and survival of premature infants with severe intraventricular hemorrhage.

OBJECTIVE: To evaluate the association between parents' ethnic/religious affiliation (secular Jewish, religious Jewish, ultra-orthodox Jewish, Muslim Arabs) and survival of premature infants with severe intraventricular hemorrhage (IVH). STUDY DESIGN: Survival of 102 infants (birth weight相似文献   

Principles for a successful professional life

Principles for a successful professional life as set out in this article are those that have been developed by Dr. Ruth Lubic over the more than 40 years that she has been a nurse and nurse-midwife. Several emanate from her experience in questioning conventional medical wisdom concerning maternity care and in pressing forward with innovative services in spite of overt and often covert opposition. Dr. Lubic credits childbearing families with providing the strength that nurtured her professional progress.     

Principles for a Successful Professional Life*

Principles for a successful professional life as set out in this article are those that have been developed by Dr. Ruth Lubic over the more than 40 years that she has been a nurse and nurse-midwife. Several emanate from her experience in questioning conventional medical wisdom concerning maternity care and in pressing forward with innovative services in spite of overt and often covert opposition. Dr. Lubic credits childbearing families with providing the strength that nurtured her professional progress.     

Care and management of the infant of the HIV-1-infected mother

Mother-to-child transmission of the human immunodeficiency virus continues to be a major global health problem. The pediatric HIV-1 epidemic is fueled by HIV-1 infection in women of childbearing age with vertical transmission in utero or at the time of birth. In resource-rich countries, the birth of an infected child is a sentinel health event signaling a chain of missed opportunities and barriers to prevention. Because the fate and ultimate HIV-infection status of the baby is inextricably linked to the infection status of the mother and her general state of well-being, we provide in this review: 1) background and state-of-the-art management guidelines for optimum maternal care; 2) strategies to minimize the risk of vertical transmission of HIV; and 3) recommendations for managing infants born to HIV-infected women. These are discussed under four case scenarios that obstetric and pediatric providers frequently encounter in their practices.     

PRENATAL SCREENING FOR ILLEGAL DRUGS

Prenatal screening for illegal drugs poses very complex ethical problems for the nurse-midwife who must make the decision whether to screen for illegal drugs and whether to report positive results to stare child abuse investigators. We argue that the results of prenatal screening for illegal drug use should not be used for determination of child abuse and that the nurse-midwife should not be required to report the results of these screens for illegal drugs to state child protection agencies. It is far from clear that required reporting offers any benefit to the fetus or future child, and there are serious ramifications of reporting for the fetus, the pregnant woman, and the nurse-midwifery profession. However, we do argue that prenatal screening for both illegal and legal drug use should be encouraged and should be done as early as possible in the pregnancy. Prenatal screening for drugs should only be used by the nurse-midwife as a diagnostic procedure wherein standard informed consent and confidentiality restraints are maintained.     

Prenatal screening for illegal drugs. Dilemma for the nurse-midwife

Prenatal screening for illegal drugs poses very complex ethical problems for the nurse-midwife who must make the decision whether to screen for illegal drugs and whether to report positive results to state child abuse investigators. We argue that the results of prenatal screening for illegal drug use should not be used for determination of child abuse and that the nurse-midwife should not be required to report the results of these screens for illegal drugs to state child protection agencies. It is far from clear that required reporting offers any benefit to the fetus or future child, and there are serious ramifications of reporting for the fetus, the pregnant woman, and the nurse-midwifery profession. However, we do argue that prenatal screening for both illegal and legal drug use should be encouraged and should be done as early as possible in the pregnancy. Prenatal screening for drugs should only be used by the nurse-midwife as a diagnostic procedure wherein standard informed consent and confidentiality restraints are maintained.     

Patient acceptance of nurse-midwife in a private group practice.

Forty private obstetrical patients cared for by a group practice employing a nurse-midwife were interviewed. Half of the study group accepted the nurse-midwife for delivery. The other 20 were delivered by an obstetrician. Acceptance of prenatal care by the nurse-midwife was found to be favorable. Patients reported feeling more comfortable with the nurse-midwife and perceived her as more understanding, sympathetic and available to answer questions than the physicians. The initial encounter with the nurse-midwife differed significantly between those in the two delivery groups. Patients accepting the nurse-midwife for delivery were more likely to have first met her alone while those who chose to be delivered by an obstetrician-gynecologist were more likely to have been introduced to the nurse-midwife by the physician. The implications of this initial "imprinting experience" on the acceptance of the nurse-midwife for delivery are discussed.     

Effects of Childhood Sexual Abuse on Childbirth: One Woman's Story

Anna Rose is a survivor of childhood emotional, physical, and sexual abuse. Much of the abuse was “submerged” until her mid-thirties, when she was pregnant with her second child, and finally began to remember and deal with the realities of what had happened to her. During her second pregnancy, Anna wrote, “it has taken me more than three years to even begin to deal with the rage I feel about my first birth experience, even though I have been in therapy most of that time. Now that I am pregnant again, the unresolved issues are coming to the surface, and intense fears that this birth will be a repeat of the first.” Anna's first child, Elliot, was born in 1987 in a hospital birthing room in the northeastern United States. Her husband Paul, a younger sister, and a close friend were present, and she was attended by an obstetrician named Bernie. She describes that birth as “19 hours of hard labor, absolutely exhausting and unmanageable, which required drugs at some point to let me sleep for a few hours.” Labor was induced by Pitocin due to premature rupture of membranes and lack of effective contractions after 12 hours. Continuous electronic fetal monitoring was used throughout labor. Anna breastfed Elliot for three years, and found La Leche League “extremely helpful and supportive” during that time. Tom, Anna's second child, was born at home in 1991. Two midwives attended the birth after she changed caregivers during the pregnancy because she “did not feel safe enough” with the obstetrician and nurse-midwife team she had chosen for this birth. She maintained the team as backup, although they did not know of her plans for a home birth. Her second labor lasted under 6 hours, was noninterventive, and “incredibly intense and painful, partly due to the abuse memories that were coming up and getting in the way and partly due to the baby's position.” We thank Anna Rose for sharing her story with Birth. Her reason for doing so is, in her words, because, “I feel strongly that it is important to share this information in an effort to educate health care professionals so that other women may be helped.”