Running head: ARAB PREGNANCY

Pregnancy in Arab Culture

Joshua Peacott-Ricardos
NURS 320
March 1, 2015
Prof. Lisa Aganon

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Pregnancy in Arab Culture

There are 21 Arab nations, commonly referred to collectively as the Arab world. The
majority of the Arab world speaks Arabic and practices Islam (Lipson & Dibble, 2008). Since
the Arab world spans an extensive land mass and because Arab people have emigrated all over
the world, specific aspects of Arab culture may vary from region to region. Islam has a profound
impact on Arab attitudes towards health and illness, including beliefs and practices regarding
pregnancy and childbirth. Arab family structures are traditionally patriarchal, with men serving
as decision makers and women filling subservient roles (Lipson & Dibble, 2008). This also
shapes the way Arab families approach reproductive health, pregnancy, and labor and delivery.
Conception and Pregnancy
Although premarital sex is generally frowned upon for men, it is tolerated much more
often than it is for Arabic women, for whom premarital sex is absolutely forbidden (Lipson &
Dibble, 2008). This can lead to unsafe abortion practices when women feel the need to hide the
fact that theyve had premarital sex. For example, work by Kohan, Sayyedi, Nekuei, and
Yousefi (2015) demonstrated that the harm caused by illegal and unsafe abortions is a significant
concern among midwives in Iran. Nurses must be sensitive to the cultural stigma surrounding
pregnancy occurring without marriage when working with Arab women.
Birth control is considered appropriate only for married couples (since only married
couples should be engaging in sexual activity), with oral contraceptives and diaphragms being
the methods of choice among this population (Lipson & Dibble, 2008). Tubal litigation may be
acceptable after the birth of the third child, but vasectomies and condom use are typically met
with resistance (Lipson & Dibble, 2008). The responsibility of birth control lies primarily with

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the woman and the nurse should be conscious of this cultural norm when discussing birth control
options.
Pregnancy is not typically viewed as a condition that requires much preparation, care, or
monitoring and is dealt with when the actual birth of the child happens (Lipson & Dibble, 2008).
Nurses may need to provide extra encouragement and reminders for these women to keep all
prenatal appointments. Arab women are encouraged by their culture, however, to rest, eat
anything they are craving, and to do minimal work (Lipson & Dibble, 2008).

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recommendation to eat well, however, is often trumped by the observance of Ramadan. During
the month of Ramadan, Muslims fast from dawn until sunset. This fasting has been associated
with the lower infant birth weights as well as the development of disabilities later in life for
individuals born to a mother who observed Ramadan during pregnancy (Almond & Mazumder,
2011). Although its important to be respectful of each patients cultural beliefs, it is also
important to ensure factual information is presented to families so that they can make informed
decisions about which traditional customs they wish to follow.
Labor and Delivery
In the hospital setting, Muslim beliefs can create difficulties for the health care team,
including Islamic rules regarding female modesty and covering, a low threshold for reacting to
pain, resistance to excessive planning, and the pressure to produce male children (Odoms-Young
& Abdulrahim, 2009). Arab women can also be indirect or agree with members of the health
care team only in order to be polite. Ensuring that health care professionals are of the same
gender (female, in this case) can help to ensure honest disclosures and shows respect for the
patients modesty. The patient should only be undressed in the presence of other women. The
father is usually not expected to participate in labor and delivery, while the patients mother,

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mother-in-law, and/or sisters are expected to be present and provide support (Lipson & Dibble,
2008). The use of a same sex family member or translator if the patient does not speak English
is also ideal (Lipson & Dibble, 2008).
Labor itself is usually a process that Arab women wait for to, Happen on its own, rather
than taking an active approach (Lipson & Dibble, 2008). Nurses can reinforce proper breathing
patterns, coach on when to engage in bearing down and pushing efforts, and provide support
(pharmacological and psychological) for pain. Arab women may have a low threshold for pain
(reporting all pain as a 10), be very expressive about pain (loud screaming, grunting, and
moaning), and be particularly fearful about labor pains (Lipson & Dibble, 2008).
Postpartum
The recovering mother is expected to be on complete bed rest while another female
family member fulfills her household duties (Lipson & Dibble, 2008). Washing the breasts and
perineum is sometimes avoided in order to avoid thinning the milk and causing pain or
infection (Lipson & Dibble). Nurses should reinforce proper hygiene and perineum care
techniques and their importance.
Breastfeeding until the age of two is encouraged under Islamic law (Odoms-Young &
Abdulrahim, 2009.) Despite this propensity towards breastfeeding, the misconception that
colostrum is harmful to the newborn is prevalent in the Arab world and delays the initiation of
breastfeeding (Odoms-Young & Abdulrahim, 2009). Nurses can function to educate mothers on
the benefits of colostrum and the early initiation of breastfeeding.
The Newborn
There are some Islamic rituals that may be performed by Arab families following
childbirth. After birth, the father whispers the Adhan into the childs right ear, which is a sort of

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prayer recognizing Allah as the only God and Mohammed as his messenger (Gatrad & Sheikh,
2001). Preferably before the infants first feeding, the Tahneek is performed by a respected
family member. A small piece of softened date is rubbed on the infants upper palate, in hopes
that the positive attributes of the person performing the ritual will be transferred to the newborn
(Gatrad & Sheikh, 2001). The Taweez may be tied around the babys wrist or neck. It is a black
piece of string attached to small pouch containing prayers or verses of the Quran written on a
piece of paper. Its purpose is to protect the childs health (Gatrad & Sheikh, 2001).
Circumcision is permitted and expected under Islamic rules, and is appropriate to discuss with
parents of male children (Lipson & Dibble, 2008).
Conclusion
Attitudes and practices regarding pregnancy and childbirth in Arabic families are shaped
largely by Islamic faith and a patriarchal societal structure. Some of these attitudes and practices
may be in conflict with generally accepted science and/or common Western beliefs and attitudes.
The nurse working with members of this population must be mindful and respectful of their
culture while at the same time presenting as much correct, factual information as possible in
order to facilitate a healthy pregnancy, labor and delivery, and postpartum period.

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References

Almond, D., & Mazumder, B. (2011). Health capital and the prenatal environment: the effect of
Ramadan observance during pregnancy. American Economic Journal: Applied
Economics, 56-85.
Gatrad, A. R., & Sheikh, A. (2001). Muslim birth customs. Archives of Disease in Childhood
Fetal and neonatal edition, 84(1), F6-F8.
Kohan, S., Sayyedi, M., Nekuei, N., & Yousefi, H. (2015). Community-based maternity care
from the view of Iranian midwives: A phenomenological study. Iranian Journal of.
Nursing and Midwifery Research, 20(1), 113120.
Lipson, J.G. & Dibble, S. L. (2008). Culture and clinical care. UCSF Nursing Press: San
Francisco.
Odoms-Young, A. & Abdulrahim, S. (2003). Health practices and nutrition and dietary practices.
In Encyclopedia of women & Islamic cultures. Retrieved from
https://books.google.com/books?id=bzXzWgVajnQC&lpg=PA208&ots=ArpUMvzmF
&dq=arab%20pregnancy%20foods&pg=PA208#v=onepage&q&f=false