In working with clients of other cultures, all health care professionals must be open and respectful to their patients’ values and beliefs. Culture can be defined as a set of learned values, beliefs, customs, and practices that are shared by a group and are passed from one generation to other. However, it is important to understand that not all members of a culture have the same behavior. A nurse must demonstrate cultural competence by understanding that each childbearing family needs are centered on their personal culture and life experience.
Having this competence gives the nurse the ability to react to cultural differences with openness, understanding, and acceptance. Pregnancy women in a variety of cultures have an array of tradition and customs that affect the care they receive. Mothers make these decisions about pregnancy and birth based on their own personal beliefs. In the United States, pregnancy and birth are often seen as medical events involving hospitals, obstetricians, and often times pharmaceutical pain relief. Many other groups do not practice this way. In 1693, what we now know as the Amish separated from the Mennonites, another Anabaptist group.
To escape religious persecution, they migrate to North American where they could freely express themselves. The Amish now live in more than 200 settlements in over 20 states in the US and one Canadian province. Within the Amish culture, pregnancy is considered a gift from God. Therefore, under no circumstances is abortion prohibited. They also frown on the use of birth control. The Amish feel that the use of contraceptives interferes with God’s plan for them to multiply. They are not opposed to using biomedical technology with childbirth as long as it is congruent with values and lifestyles.
For example, fetal monitors are accepted because they facilitate a better outcome for both the mother and child. Prenatal testing, however, is seen as a waste of funds. They believe that God will accept all children regardless of problems identified prenatally. Instead of hospitals, many Amish individuals utilize birth centers. A nurse is always there and a doctor is usually on call. These centers were made to limit the cost of childbirth so young families would not stop reproducing due to the high cost of hospital centers. There centers also provide care congruent with their culture making it an ideal facility.
The uses of hospitals are prohibited as long as all standards are followed similarly to how they would be within an Amish birthing center. Women of this culture are normally only sent to an acute care facility when a medical emergency is present. It has been said that Amish birth “go quick”. This stumbles many because they do not acquire prenatal care, do not usually deliver in hospitals, and do not usually accept pharmaceutical pain relief during birth. One theory discusses their lack of fear and anxiety of the birthing process.