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What Mothers Need Series: Culturally and Linguistically Appropriate Maternal and Child Health Services

By Dr. Yanira Cruz, NHCOA President and CEO

Mother, grandmother and babyMotherhood is simultaneously one of the most beautiful and difficult experiences in a woman’s life, the effects of which can be seen in the health of subsequent generations. Health outcomes that span a person’s life are increasingly being linked to pregnancy and early childhood (Marmot, 2003). Hypertension, heart disease, and diabetes have all been linked to experiences in the womb and during infancy (HRSA, 2011). What is often excluded from discussion, however, is how parents, particularly new mothers, learn to care for their children. In diverse communities throughout the United States, learning to be a mother means balancing medical recommendations with traditional customs. This balancing act can, and often does, mean deciding between conflicting recommendations.

Recently, researchers at Emory University set out to answer the question: What do new mothers need? To answer this question, the team of investigators spoke with new mothers and medical providers across Georgia (Gazmararian et al., 2013). Mothers and their health care providers were nearly unanimous in declaring that the most urgent maternal and child health need is culturally and linguistically appropriate services and health education.

In some areas, such as infant bathing or umbilical aftercare, mothers from all linguistic and socioeconomic backgrounds indicated there was simply no information. In other arenas, such as Sudden Infant Death Syndrome (SIDS), the information was readily available in English and Spanish, but it did not resonate with the mother’s cultural and instinctual understanding of proper childcare (Merino et al., 2012). Moreover, almost all health care providers indicated that they found it frustrating that mothers either did not know infant care basics or knew and chose not to adhere to them. As a result, many providers provide little, if any, patient counseling around topics where they feel cultural influences will outweigh their medical recommendations. The result is new mothers that are either uninformed or misinformed about their own postpartum care or the care of their newborns and crave more information from their providers. Given the importance of early health throughout the life course, approaches to increasingly diverse populations of mothers must grow to meet the changing needs of maternal and child health in the United States.

Health education and patient-provider communication are of vital importance to the development of appropriate parenting skills and health of children throughout their lives. In order to improve communication between providers and mothers of diverse cultural and linguistic backgrounds, maternal and child health education must evolve. This is even more important in multigenerational households where grandmothers have a wealth of parenting advice to impart on new mothers. In the Hispanic community in particular, many of the practices new mothers adopt are customs and traditions passed down from generation to generation. Moreover, the evolution of recommendations and treatment standards over time can further complicate the recommendations new mothers must balance.

Approaches to increasingly diverse populations of mothers must grow to meet the changing needs of maternal and child health in the United States.

What we need is more, rather than less, discussion. Current approaches to parenting education leave knowledge gaps for new mothers, particularly when existing messages do not resonate across different cultures. Identifying and addressing those gaps is the first step to improving parenting knowledge and health outcomes throughout the life course. Moving forward means addressing some of the realities of motherhood in the United States:

  • Leverage the concept of good and attentive mothering that is fundamental to Latino and other diverse cultures as a way to connect health education with culture
  • Address infants’ reactions as an important deciding factor for mothers (e.g. sleeping longer on their stomachs, more frequent feeding when breastfed vs. bottle fed, etc.)
  • Understand that co-sleeping is a culturally ingrained practice for some populations, such as Latinos, and may be an immutable practice
  • Allow room in care recommendations for mothers that may on occasion co-sleep with their infants or otherwise take the path of least resistance from time to time
  • Acknowledge that recommendations evolve over time and that what we know today about maternal and child health may change in a few years when a mother has her next child
(Adapted from When Lack of Knowledge isn’t the Problem)

By advancing our approaches to maternal and child health education in tandem with changing U.S. demographics, we can better address the needs of diverse communities and work towards creating well-equipped mothers and healthier generations.

This post is part of the Mother’s Day #WhatMothersNeed week of action during which NHCOA is joining several national organizations and advocates to raise awareness about quality maternity care, pregnancy discrimination, paid family and medical leave, paid sick days, fair pay, affordable health care, and more. Join the conversation May 5-9, 2014 at 3pm ET on Twitter and tell us #WhatMothersNeed.