The ethnic traditions which are strong in rural sociocultural
life affect the mother and baby care
17,26.
The harmful traditional applications about health in
postpartum period can affect the recovering process of
the mother and the baby, can hinder receiving effective
treatment, can result in disability, disease even death
27.
43.1% of women included in the study are illiterate.
According to the results of Demographic and
Health Survey of Turkey (DHST) in 2013, the illiteracy
rate in the south east of Turkey for ages between 15- 49
is 22.6%28. The results of our study corresponding
with DHST show that the education problem of women
living in the region is continuing.
The average income of the women included in the
study was reported to be 960.06±884.21 TL (Turkish
Liras). In the result part of a report by Turkish Statistical
Institute (TSI) in 2009 the poverty threshold for a
family of four was estimated to be 825 TL29, and for
2013 it was 1144 TL30. In November 2010 the
threshold of poverty announced by unions was 2807,36
TL31 for a family of four, according to Confederation
of Turkish Trade Unions (TURK-IS) the poverty
threshold for a family of four in May 2015 was
4.394,87 TL32. According to the statements of
women included in our study the average income of the
families are lower than the ones defined by TSI and the
trade unions. Considering the fact that the field study
was carried out in 2010-2011 it can be said that the
incomes of the families of the women are low.
It has been defined that 99.8% of the women covered
by the study had pregnancy and the average of
live children is 4.40±2.75. According to 2013 data of
Turkish Demographic and Health Survey Report
(TDHS), it has been reported that the average of live
birth number of married women is 2.32 and the average
of living children is 2.2328. The facts determined in
our study are over the average numbers of Turkey.
57.3% of the women included in the research stated
that they had birth at hospital. According to the
2008 results of TDHS the middle east, southeast and
northeast Anatolia were reported to have the lowest
percentage of birth deliveries at hospital with the results
respectively by 65%, 75%, 76%33. In the 2013
data of TDHS the rates were reported to be respectively
91%, 92% and 89%28. It is seen that in this study the
rate of giving birth at health centers is lower than the
two declarations.
5.5% of the women in our research reported that
they had given birth at home with the help of health
staff and 37.2% of them said they had given birth at
home with the help of a traditional midwife. According
to data of 2013 by TDHS very little doctor help was
got during the births that took place away from health
centers (1%) and in only 16% of them nurses or midwives
served28. In a similar study by Dinç21, it
was stated that 48.3% of women gave birth at home got
help from the district traditional midwives. Statistics
show that 53% of the births are carried out at home in
Zambia and it was stated that only during a few of
them (5.4%) help was available from midwives
(Mbusas) with traditional experiences34. Getting
help from experienced health staff during the birth is of
great important to prevent mother and neonatal deaths.
The probability of getting help from educated health
staff in births happening away from health services
decreases and traditional methods can be used more.
77% of the women included in the research said
that when they had a health problem they applied to a
doctor while 20.8% of them said that they tried to solve
the health problem by traditional methods they had
learnt from their family or environment. In the research
by Eğri called “The Traditional Applications for mother
care in postpartum period for married women between
15-49’’ it is reported that the rate of seeing a
doctor in case of a health problem is 47.2%, the rate of
solving the problem by traditional methods they already
know is 45.5%2. Although compared to Eğri’s
work the rate of seeing a doctor in case of a health
problem is higher in our study, in Kocataş and his
friends’ study13 there are high rates of using traditional
methods for overcoming different health problems.
It can be interpreted that the using of traditional
applications to overcome health problems is at a rate
that the issue must be dealt with and precautions should
be taken.
46.7% of the women covered by the study reported
that they had applied and/or would apply a traditional
method learnt from elder family members, neighbors or environments in postpartum period. It is seen that in
the studies carried out on the subject about the applications
of traditional methods vary in Gölbaşı and Eğri’s
research35 between 11.3% and 91.5%, in Geçgil and
his friends’ research36 between 1.1% and 82.8%, in
Şenol and his friends’ research14 between 9.1% and
56.8%.
While 23.1% of the women included in the study
stated that the traditional applications were of no importance
at all in solving health problems or preventing
them, 76.9% of the women said that using traditional
applications was important for them to various extents
(Table 1). In the study Eğri carried out in Tokat province2, 27.5% of women stated that the traditional
applications were of no importance at all in solving
health problems or preventing them and 72.5% of the
women said that using traditional applications was
important for them to various extents. Compared to
Eğri’s study the height of the rate of our study can be
interpreted as the efficiency of the traditional structure
in the region.
94.3% of the women reported that in postpartum
they had used any of the traditional applications for
maternity care (Table 2). It has been stated that among
these applications, postpartum women’s avoiding sexual
intercourse for 40 days is the most common application
(85.3%). Believes and applications experienced
in postpartum period have brought out significant stereotypical
differences between western and nonwestern
women. But some similar characteristics about
women’ avoiding sexual intercourse for a certain time
in postpartum period is significant. In the far-east,
according to Chinese Zou Yue Zi traditions, women
should avoid sexual intercourse for a month after the
delivery37. In Kaewsarn’s study38 covering 500
women in Taiwan all of the women (100%) reported
that sexual intercourse should be avoided between 7-
450 days corresponding an average of 63 days. In
Gölbaşı and Eğri’s study35, the rate has been found
90.8%. In Geçgil and his friends’36 research carried
out in Adıyaman, the rate of women avoided sexual
intercourse for 40 days following the birth is 57.9%. It
is scientifically suggested that women should not have
sexual intercourse for six weeks because of infection
susceptibility in postpartum period39. The length of
this period varies related to social, religious, traditional
and intercultural agents.
It has been reported that among common traditional
applications for women in postpartum period, wrapping
the postpartum woman’s belly comes in the second
place with 48.1% in this research. In Geçgil’s
study36, the rate of the mentioned application has
been detected as 64.5%. In Gölbaşı and Eğri’s study35, this rate is 64.8%. In Öztürk and Katabi’s study40, comparing Turkish and Persian women it has
been defined that 92% of Turkish women and 99.3% of
Iranian women apply traditional application such as
tying something on the belly button to help the uterine
involution. It can be accepted as a moderate application to put a corset on in order not to let their abdomen
remain swollen and not have a big belly. But wrapping
the abdomen tightly can cause the muscles recover late
and can make the involution process may extend35.
93.7% of the women covered in the study reported
that they had used any of the traditional applications to
enhance the breast milk in the postpartum period (Table 2).
Among these applications feeding the mother
with egg and boiled grape juice takes the first place
(84.0%). The other applications are as follows: feeding
the mother with liver and meat (82.8%), with deserts
(81.6%). Gölbaşı and Eğri35 have fixed in their
study that 89% of the women applied special applications
to enhance the breast milk. Among these applications
are consuming juicy meals 71.3%, drinking weak
tea 63.7%. 68% of the women covered in the study of
Işık et al in Mersin reported applications to enhance the
breast milk. Drinking maternity syrup (boiled), grape
syrup, having food like liver are included in these applications36. In the study Geçgil and his friends36
made in Adıyaman, the most common application to
produce milk is eating a kind of dessert called Bulamach
made of flour, sugar, butter and nuts. Drinking
grape syrup and butter mixture follows this application
(69.6%). In the study Dinç21 carried out in
Şanlıurfa, plenty of breastfeeding takes the first place
among the applications to enhance the breastmilk with
a percentage of 43%. Besides breastfeeding is very
important in the new born’s development, protecting
and maintenance of the health, it is also important for
the mother’s health to have adequate and balanced
nutrition in lactation period41. That the mothers
don’t feed the babies in the first six months just with
breastfeeding and their shifting to additional nutrient at
an early phase is because of the opinion that they think
their breast milk is not enough25. The fact that the
statements about the theme in Turkey doesn’t have
differences regionally and that there being an application
in nearly every region can be evaluated as the
mothers’ fear that their breast milk is not enough
stemming from the mothers’ emotional approach to
their babies.
37.8% of the women covered in the study stated
that in the postpartum period some certain food
shouldn’t be given to the postpartum woman (Table 2).
Among these dry legumes takes the first place (90.5%).
In Işık and his friends’42 similar research, it has
been fixed that the rate of not eating food such as peas,
chickpeas, grapes and milk thinking they are inconvenient
is 19.1%, the rate of not drinking water is 23.4%.
In a study conducted in India, it has been expressed
that the mother shouldn’t have cold food and water in
postpartum period43. Though the food restriction
may vary regionally, the rate of restriction of legumes
is quite high as fixed in our research. Actually dry
legumes which are the source of protein and among
thought to be inconvenient food, is an important nutrient
supply with their rich fibers and when taken with
sufficient liquid it enhance the breastmilk. Yet traditions and beliefs as behavior can get ahead of scientific
truths.
In Turkey for the feverish state of women after the
birth, traditionally the term ‘Albasması’ (flush) is used.
96.7% of the women involved in the study said that
they had heard about the concept “Albasması” (flush).
45.0% of the women expressed that they believed in
the flush, 94.9% of them said that they applied an application
to protect women from the flush. Among the
applications applied by the women covered in the
study, hanging the Holy Quran in the room of the postpartum
women to prevent the flush takes the first place
with 96.8%. This application is followed by putting
needles under the postpartum woman’s and baby’s
pillow (54.6%), postpartum woman’s not entering the
scoopish places (50.0%). In Eğri and Gölbaşı’s study35, it has been reported that among the applications
to prevent the flush, putting bread, the Holy Quran,
scissors, broom in the room the postpartum woman
sleeps (89.4%) and putting needles under the postpartum
woman’s pillow (71.8%) are the most common
applications. Biltekin and his friends20 pointed out
that in their studies rate of applications protecting the
mother against the flush is 72.3% the most common
application is tying a red cloth with a rate of 64.7%.
For the applications to prevent the flush, Çakırer and
Çalışkan44 reported that 55.4% of the women should
cover themselves with a red cover, Işık and his friends42 reported that staying indoor for 40 days at most
(48.50%), Geçgil and his friends36 reported that not
leaving the mother alone for 40 days with a rate of
62.6% and putting garlic, bread, the Holy Quran under
the mother and baby’s pillows. The results of the researches
and our studies are corresponding and it can
be regarded as an indicator that this belief is still being
kept alive in various parts of Anatolia.
52.9% of the women involved in the study have
reported that they had any of the traditional applications
to pass the flush (Table 2). Applications such as
getting women have bath on the 40th day after the birth
(49.1%), pouring lead (48.0%), saying their prayers
(47.7%), getting an imam saying prayers for the woman
(33.7%) have been fixed as among the most commonly
used ones. In Gölbaşı and Eğri’s studies35,
women declared that 81% of them say prayers, 48.2%
of them have bath at the 40th day after the birth, 35.1%
of them go to imam to get prayers for them to pass the
flush. The case believed to be Albastı (flush) among
people is indeed the fever related to infections after the
birth. In this case instead of applying to the health
centers the women turn towards traditional applications,
as a result because of the delayed treatment maternal
mortalities may occur2.
36.1% of the women included in the research reported
any of ceremonial application to pass the 40th
day (Table 2). In Eğri and Gölbaşı’s study35, they
fixed the rate of the application which the postpartum
woman passes the 40th day of the birth ceremonially is
91.5%. The 40 days after the birth is very important both for the mother and for the baby. The baby and the
mother are tried to be saved by traditions and beliefs as
being susceptible to all kinds of harmful effects. And at
the end of the 40 days to celebrate the finish of this
period, the mother and baby are greeted for the 40 days
ceremonially. In some regions ceremonies are done on
the 3rd, the 7th day and after the 20th day under the name
of half 40th45. These 40th day celebrations can be
thought as harmless ones, besides it can also be regarded
an application to give psychological relief to the
family.
It has been fixed that the older the women are the
more the rate of applying / to apply traditional methods
after the birth (p<0.05, Table 3). In Eğri’s study2
about the theme, a reasonable correlation between the
age and applying traditional methods has not been
fixed. The findings of our result suggest that the elderly
women stand by their traditions and culture firmer.
The higher the level of education among the women
involved in the research is, the less the rate of applying
and/or to apply traditional methods to themselves
after the birth is (p<0.05, Table 4). In their study conducted
in Elazığ, Açık and his friends46 stated that
the higher the education level of women gets the less
the rate of the traditional methods they know and apply
gets. According to the research findings of Tortumoğlu
and his friends47, the traditional applications rates
have been fixed high with those with low education
level. Kaewsarn and his friends38 report that the
mothers applying to traditional applications in postpartum
period are those with low education level and
those living in the rural areas. Compatible with the
general literature, it can be stated that the height of
education level makes mothers push the traditional
applications for their health away from themselves.
According to the study, the more the women’s
monthly income is, the less the rate of applying traditional
methods to themselves in postpartum period
becomes (p<0.05). The low income level may affect
reaching health services negatively. It can be thought
that this situation increases the tendency to the use and
adoption of the traditional treatment methods.
It has been fixed that the rate of applying a traditional
method to themselves among women married at
an age under 18 is higher than those married at or over
18 (p<0.05). Aliefendioğlu and his friends48 stated
in a study they conducted in Kırıkkale that mothers
gave birth less than 18 years old are more inclined to
use traditional methods for themselves. These findings
maybe an indicator showing that mothers married at
early ages complete their lack of knowledge and experience,
their insufficiency, their deficiency for themselves
by applying traditional methods or they may be
affected more easily by the older people at home who
form the traditional structure.
Women’s having social security doesn’t change the
fact that they applied or are going to apply a traditional
methods to themselves in this study (p>0.05). Contrary
to our study findings, in Dinç’s research21 conducted in Şanlıurfa, it has been stated that mothers without
a social security apply to traditional applications more
and the difference between the existence of a social
security and using a traditional method is statistically
reasonable.
A relationship between the family type and the rate
of women’s applying the postpartum traditional methods
hasn’t been fixed in this study (p>0.05). But in
Eğri’s research2, it has been reported that women
living in large families apply more traditional applications
than the women in nuclear families. It can be
thought that the reason of the differences in our research
findings is that the traditional methods’ remain
important regardless of the family being large or nuclear.
The more the number of the children of the women
involved in the study is, the higher the rate of application
of the traditional methods becomes (p<0.05). This
case can be explained as the lack of time and value to
be given to the large number of children cause the
inclination towards the traditional methods.
It has been fixed in this study that affirmative
health attitudes such as giving birth at the hospital
seeing a doctor in case of a health problem and not
giving importance to the traditional methods reduce the
application of traditional methods (p<0.05, Tables 5-
7). It has been thought that putting into practice the
affirmative health opinions and attitudes cast out people
from traditional methods.
As a result, in this research the attitude of the married
women living in the center of Kızıltepe, Mardin
province, towards the traditional methods being applied
or to be applied to themselves in postpartum period has
been fixed to be at a high rate. A significant proportion
of women (76.9%) expressed that in solving the health
problem or preventing them the traditional methods are
important for them to various extent.
According to these results;
- It`s seen that harmful or harmless traditional methods
for mother care continue surviving in the society
despite varying interculturally.
- Especially the health care staffs providing the primary
health service should know the culture of the
society they serve, should know their sensitivity to
the traditional applications and must absolutely emphasize
the harmful applications the must be
changed.
- That the women’s and their husbands’ education
level should be elevated in relation with avoiding
from harmful traditional applications should be considered
important
- Health services in both prenatal and postpartum
periods should be considered as important and during
this monitoring mother should be educated how
to look after themselves in postpartum period and
non-medical applications should be reduced.
- Considering that the traditional applications are
more in poor societies, the efforts to elevate the so cioeconomic level of the region should be given weight
to.
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