Yu Duan practices as embodying tradition, modernity and social change in Chiang Mai, Northern Thailand

In this paper I examine the traditional postpartum beliefs and practices which still exist in northern Thailand today. The paper is based on qualitative research involving in-depth interviews with 30 women in Chiang Mai province. Beliefs and practices remain an essential part for postpartum care for women and have important consequences for women's health and wellbeing in northern Thailand. Many Thai women see their reproductive health problems as the consequence of inadequate postpartum practices. Thai women also believe that the effects of postpartum taboos would continue for the rest of their lives. Although the traditional postpartum beliefs and practices abound, the level of adherence differs according to the social structure of the women and their families. Poor rural women seem to hold on to their traditions more strongly than their urban counterparts. Urban middle class women in particular embody modernity in their thinking and behaviours concerning postpartum practices. But modernization has brought with it medical dominance. Due to their medical knowledge, doctors retain authority over both knowledge and status. The consequence of this dominance is the attempt to dismiss local traditional knowledge and practices. Although the pattern of traditional postpartum beliefs and practices is changing, it is still observed in northern Thailand. I contend that postpartum care for women incorporates local traditions so that women's health can be optimized at the time when they are in the most vulnerable stage of their lives.     

When giving life starts to take the life out of you: women's experiences of depression after childbirth

OBJECTIVE: To capture the missing voices of mothers who are suffering postnatal depression. DESIGN: Qualitative methodology using in-depth interviews. SETTING: Melbourne, Victoria, Australia. PARTICIPANTS: 10 women who had been clinically diagnosed and admitted to a large hospital mother and baby unit in Australia. FINDINGS: Stigma is frequently attached to women who are unhappy after the birth of their child, because they are not coping with the demands of motherhood or do not instantly bond with, and love, their baby. As a result, postnatal depression can be a terrifying and isolating experience for women. It is also a complex illness with varying degrees, reasons for onset and medical treatments. IMPLICATIONS FOR PRACTICE: In this study, we have captured the emotions and feelings of women first hand, allowing us and health-care practitioners who are treating women to truly understand this debilitating illness. It is hoped that, in making the wider community aware of depression after childbirth, fewer women will suffer in silence.     

Experiences from pregnancy and childbirth related to female genital mutilation among Eritrean immigrant women in Sweden

OBJECTIVE: to explore Eritrean immigrant women's experiences of female genital mutilation (FGM) during pregnancy, childbirth and the postpartum period. DESIGN: qualitative study using an ethnographic approach. Data were collected via tape-recorded interviews. SETTING: interviews in the Eritrean women's homes located in and around Uppsala, Sweden. PARTICIPANTS: 15 voluntary Eritrean immigrant women. DATA COLLECTION AND ANALYSIS: Semi-structured interview and open-ended questions were used. The interviews were tape-recorded, transcribed verbatim and then analysed. FINDINGS: six themes of experiences of FGM among Eritrean women during pregnancy and childbirth were identified. They are (1) fear and anxiety; (2) extreme pain and long-term complications; (3) health-care professionals' knowledge of circumcision and health-care system; (4) support from family, relatives and friends; (5) de-infibulation; and (6) decision against female circumcision of daughters. KEY CONCLUSION AND IMPLICATIONS FOR PRACTICE: the Eritrean women had experiences of FGM and had suffered from its complications during pregnancy, childbirth and the postpartum period. Midwives and obstetricians should have competence in managing women with FGM, and they need increased understanding of cultural epistemology in order to be able to provide quality care to these women. At antenatal centres, circumcised women should be advised to de-infibulate before pregnancy. Special courses about anatomical differences should be offered to these women and their husbands. It is also important to inform them about Swedish law, which prohibits all forms of FGM.     

Outbreak of varicella-zoster virus infection among Thai healthcare workers.

OBJECTIVE: To evaluate the correlation between self-report of a prior history of chickenpox and results of varicella-zoster virus (VZV) immunoglobulin (Ig) G serologic test results in an outbreak of VZV infection among Thai healthcare workers (HCWs) and to conduct a cost-benefit analysis of establishing routine VZV immunization as part of an occupational health program on the basis of the outbreak data. METHODS: All exposed patients received prophylaxis and the HCWs in our 3 intensive care units (ICUs) were prospectively evaluated. HCWs were assessed for disease history and serologic evidence of VZV IgG. A cost-benefit analysis was performed. RESULTS: After 140 HCWs and 18 ICU patients were exposed to VZV, 10 HCWs (7%) with active VZV infection were relieved from work until skin lesions were crusted. Acyclovir (ACV) was prescribed to all 10 HCWs with active disease, and all 18 exposed patients received prophylaxis with ACV. Of 140 HCWs, 100 consented to longitudinal follow-up. Twenty-three (100%) of the HCWs who reported a history of chickenpox also had serologic test results that were positive for VZV IgG, compared with 30 (39%) of 77 HCWs who reported no prior history of chickenpox, yet had test results that were positive for VZV IgG. Reported history of chickenpox had a sensitivity of 43%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 61% with respect to VZV infection immunity. The total cost estimate for this outbreak investigation was $23,087. CONCLUSIONS: An HCW's reported history of chickenpox was a reliable predictor of immunity; a report of no prior history of chickenpox was unreliable. Our cost-benefit analysis suggests that the costs of an occupational health program that included VZV surveillance and immunization for the next 323 HCWs would be approximately equal to the excess costs of $17,227 for the ACV therapy, HCW furloughs, and staff overtime associated with this outbreak.     

Life as mothers in a new land: the experience of motherhood among Thai women in Australia

In this article, we examine the accounts of 30 migrant Thai women in Australia who had become mothers. The women recognized that they had entered a new environment, which was different from their previous one. This had a marked impact on their lives as wives and mothers. Cultural differences play a major role in their coping with motherhood and the mothering role. We find that the women had several main concerns in their new land: social isolation, different childrearing and child disciplinary practices, and the desire to preserve Thai culture. Most women wish to have more children in their new land, but others are concerned about social and political environments in Australia. We also find that the social class of the women and the ethnic background of their spouses play an important role in their coping with motherhood and childrearing. We conclude that motherhood and mothering is a great challenge, which is made more complex when it is combined with migration. This is important if we are to understand motherhood from an ethnicity perspective. Only then may we see better health care for immigrant women who choose to become a mother in their new land.     

Pregnancy loss: what it means to women who miscarry and their partners

This paper reports results from six women who had miscarried and their partners in Melbourne. A qualitative approach, namely in-depth semi-structured interviews, was utilised to obtain information. Several themes emerged from the data. The findings of this study show that women and men experienced a variety of feelings in reaction before, during and after the miscarriage. These feelings varied in type, intensity, and duration in which the men generally experienced less intense feelings for a shorter period of time as compared to the women. We argue that support and counselling be provided not only for women who miscarry, but also for their male partner, as the men may have fewer means to express their grief due to the "social expectation" of male roles.     

Anti-HIV-1 protease- and HIV-1 integrase activities of Thai medicinal plants known as Hua-Khao-Yen

Ethanolic- and water extracts from five species of Thai medicinal plants known as Hua-Khao-Yen were tested for their inhibitory effects against HIV-1 protease (HIV-PR) and HIV-1 integrase (HIV-1 IN). The result revealed that the ethanolic (EtOH) extract of Smilax corbularia exhibited anti-HIV-1 IN activity with an IC50 value of 1.9 microg/ml, followed by the water extract of Dioscorea birmanica (IC50 = 4.5 microg/ml), the EtOH extract of Dioscorea birmanica (IC50 = 4.7 microg/ml), the water extract of Smilax corbularia (IC50 = 5.4 microg/ml), the EtOH extract of Smilax glabra (IC50 = 6.7 microg/ml) and the water extract of Smilax glabra (IC50 = 8.5 microg/ml). The extracts of Pygmaeopremna herbacea and Dioscorea membranacea were apparently inactive (IC50 > 100 microg/ml). Interestingly, only the EtOH extract of Dioscorea membranacea showed appreciable activity (IC50 = 48 microg/ml) against HIV-1 PR, while the other extracts possessed mild activity. This result strongly supported the basis for the use of Smilax corbularia and Dioscorea membranacea for AIDS treatment by Thai traditional doctors.