MATEC Web of Conferences 150, 05067 (2018) https://doi.org/10.1051/matecconf/201815005067 MUCET 2017

Traditional Belief and Practice on Postpartum Recovery among Mothers in East Coast of Peninsular Malaysia

Radiah Abdul Ghani1,*and Saezah Salehudin1 1Department of Biomedical Science, Kulliyah of Allied Health Sciences International Islamic University Malaysia,25200 Kuantan Pahang

Abstract. Postpartum care is highly important to prevent maternal and infant morbidity. In Malaysia, there are several traditional postpartum care practices by mothers. Different states adopted different ways to perform those practices. In spite of long and established practices in Malaysia, its effect and safety profile is not well understood. This study aims to gain an understanding of the traditional practices that Malay women follow in relation to postpartum care and the rationales underpinning such practices. A cross sectional study (n=100) was conducted using self-administered questionnaire consists of demographic information, practice of postpartum care and knowledge of postpartum care. Data was analyzed using Statistical Package Social Software (2.0). The findings shown that, there was no significant association of socio-demographic data with confinement period (p>0.05). For postpartum dietary practice, there were only association between age and encourage more water intake (p=0.047, p<0.05) and also between number of children and prohibit greasy food (p=0.032, p<0.05). For association between socio-demographic data and postpartum physical practice, there was only association between age and body scrub (p=0.046, p<0.05). The most significant factor that influenced postpartum care practice and its knowledge was family tradition with 83% and 97%, respectively. Traditional postpartum care practice is still significant and dominant among mothers in Kuantan, Pahang. This information is important for health care professional to educate women and provide strategies to help them to integrate their beliefs and the practices recommended in contemporary health care practice.

1 Introduction and birth are seen as socially important transition periods that should be taken seriously. For women that delivering their first baby, that moment is probably the most significant experience and gives impact in their life [16]. The process to become a mother is defined as a process of learning, discovery, appreciation and acceptance of new role of a woman which leads in a worthwhile and valuable experience [7]. While the begins immediately after the birth of the baby and extends for about six

* Corresponding author: [email protected]

© The Authors, published by EDP Sciences. This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (http://creativecommons.org/licenses/by/4.0/). MATEC Web of Conferences 150, 05067 (2018) https://doi.org/10.1051/matecconf/201815005067 MUCET 2017

weeks during which, the mother’s body return to the nonpregnant state ,. There are also physical changes, strong emotions, altered and new relationships and adaptation to a new role . There are maor changes occur during postpartum period in the body that determine mothers’ wellbeing and epected for a healthy future . omplications may come up and if they are not treated immediately and efficaciously can lead to illhealth and death to mothers, babies or both . The risk of morbidity and mortality is highest in the first si weeks after birth but stays high after weeks because of issues such as untreated anaemia or repeat pregnancy . Thus, improvement of delivery of postpartum care has been neglected as a strategy for improving maternal, infant, and child health. The practices of postpartum care aim to restore the normal function of seual and reproductive organs, increasing wellbeing and energy of the mothers. The normal feedback mechanism of human body will involve such as wound healing promotion and weight loss. ue to these reasons, postpartum care is a priority programme worldwide which aims to restrain maternal deaths and for aesthetic purposes. omen in sian countries are doing well after compared to those in estern countries . They find that many postpartum complications are nearly noneistent especially postpartum . onversely, of postnatal mothers suffer moderate to severe postpartum depression in developed countries. They believe this is due to the traditional postpartum care. owever, it has still not been fully understood whether postpartum care practices give any significant effect on women’s health or not. The health care providers are not able to come out with the benefits or negative effects on health due to inadeuate study on the postpartum care practice. n spite of long and established practices in alaysia, its effect and safety profile is not well understood. ence, this study was conducted to identify knowledge and practice of postpartum care among mothers in one area in ast oast of eninsular alaysia uantan, ahang. oreover, this study aims to determine association of sociodemographic data with confinement period, postpartum dietary practice and postpartum physical practice. t is also to identify factors that influence postpartum care practice among mothers in uantan and lastly to investigate factors that contribute to knowledge of postpartum care among mothers in this selected population.

2 Material and Methods tudy design and sampling crosssectional study was conducted among respondents among mothers in selected area in eninsular alaysia which is uantan, ahang. ubects were selected by using the method of purposive sampling based on the inclusion criteria which were women who have given live birth from until , given live birth in uantan and the resident of uantan, ahang and eclusion criteria which were women who do not understand alay or nglish language and cannot communicate effectively, women who have chronic disease or on medication and also and stillbirth cases. The determined sample sie for this study was calculated using single proportion sample sie calculation formula. The selected subects were asked to complete a prepared uestionnaire which included all appropriate issue of knowledge and practice of postpartum care. The uestionnaire was divided into three categories which were personal details, practice of postpartum care and knowledge of postpartum care. The multiple choice and ikert scale format were selected for simplicity in scoring and data management.

nstrument development The prepared uestionnaire included all appropriate issue of knowledge and practice of postpartum care. The uestionnaire was divided into three

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categories which were personal details, practice of postpartum care and knowledge of postpartum care. The uestions of personal details were age, ethnicity, and religion, level of education, occupation and number of children. part from that, for practice of postpartum care, it included confinement period, types of practices, complications, dietary intakes and supplement consumed. The uestions in the category of knowledge of postpartum care were to evaluate the basic information about postpartum care such as the origin of knowledge, reason behind the practice and purposes of the practice. The multiple choice and ikert scale format were selected for simplicity in scoring and data management.

alidity and reliability of uestionnaire To validate the accuracy and validity of uestionnaire, the content id reviewed by panel of epert. pilot study was conducted within selected group of 30 among International Islamic University’s staff. Results from pilot study showed the ronbach alpha . and . for section and , respectively.

thical consideration The approval to conduct this study was obtained from ean, ulliyyah of llied ealth ciences and nternational slamic niversity alaysia thics ommittee. The guideline stated was strictly followed before conducting this study. rior to taking part in this study, respondents were informed about the obective of the study. ll respondents were asked to sign on consent form confirming their willingness to participate. ll respondents were assured that confidentiality would be maintained.

tatistical analysisll the collected data was uantitatively analyed using tatistical ackage for ocial ciences version . The test used was hisuare test to determine association of sociodemographic data with confinement period, postpartum dietary practice and postpartum physical practice. or hi suare test, the data must meet the assumption by cell with and epected count less than five must be . The minimum expected count must be ≥1. If the assumption was not met, the Fisher’s exact test can be used. The data showed statistical significance relationship with pvalue .. igures and tables, as originals of good uality and well contrasted, are to be in their final form, ready for reproduction, pasted in the appropriate place in the tet. Try to ensure that the sie of the tet in your figures is approimately the same sie as the main tet point. Try to ensure that lines are no thinner than . point.

3 Results There were eligible mothers participated in this study. The age of respondents ranged from to years old. ost of them were in the age group of followed by . ost of the respondents were alays, uslims, employed and had one child. The highest level of education was up to tertiary school. There was no significant association of demographic data which were age, level of education, occupation and number of children with confinement period ρ. Table .

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It has een found that not all demographic data age level of education o status and numer of children affected the postpartum dietary practices which consisted of prohiit cold food prohiit acidic food prohiit greasy food limit water intae encourage warm food and encourage more water intae. here were only association etween age and encourage more water intae ρ0.0 ρ0.0 ale and also etween numer of children and prohiit greasy food ρ0.03 ρ0.0 for postpartum dietary practice ale 3). Other than these two mentioned practices were not affected by any respondents’ socio demographic data. here were ten postpartum physical practices which were hot compress corset massage hers ath param pilis sauna ody scru omam and oil ath associated with sociodemographic data age level of education o status and numer of children. owever there was only association etween age and ody scru ρ0.0 ρ0.0 ale .

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he factors that infenced respondents to do postpartm care practice were sef beief famiy tradition famiy pressre infenced by cose friends and conenience. t has been fond that the famiy tradition was the most infenced factor amon respondents with 3 of the mothers. hen foowed by sefbeief ) conenience ) other factors ) and famiy pressre ). he effect of cose friends was the east factor that infenced respondents to eperience postpartm care practice ) i. ).

here were fie eements that contribte to nowede of postpartm care which were famiy tradition acired heath edcation recommended by internet and others. amiy tradition has contribted the most to nowede of postpartm care amon mothers

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with . he east factor that contribted to postpartm care nowede was other factors ). cired heath edcation internet and recommended by midwife hae contribted to nowede of postpartm care with 3 and respectiey i. ).

4 Discussion here was no sinificant association between sociodemoraphic data with confinement period which means sociodemoraphic data did not affect confinement period of the mothers after deiered a baby. his findin was simiar to the stdy done in enan which was the association between sociodemoraphic data and confinement period is not statisticay sinificant . t means that the perceied minimm confinement period is not affected by the different settins of the stdy bt it is more iey to be based on the beief of the mothers. aay women especiay sim practice a day period of rest based on samic beiefs tern 3). n contrast hinese and ndian women practice their confinement for 3 days . hs it shows that the confinement period strony depends on the beief of the mothers and does not infenced by other factors. or association of sociodemoraphic data and postpartm dietary practice there were ony two statisticay sinificant associations between sociodemoraphic data and postpartm dietary practice. here was association between ae and encorae more water intae and association between nmbers of chidren and prohibition of reasy food. he encoraement of water intae is ood becase it can decrease the ris of dehydration and constipation amon mothers. ater is the most crcia ntrient for hman and the absence of it soey can be etha within days. part from that the short and onterm effects of water on hman heath are ery cear . oweer it was reported that association between sociodemoraphic data and postpartm dietary practice shows that the mothers are more iey to restrict their water intae een thoh the imitation of water and certain foods ie eetabe and frit intae may ead to a ris for constipation dehydration and mantrition . t shows that peope are not reay aware the importance of water in maintainin their heath. eertheess the rest of a stdy in enan on association of sociodemoraphic and prohibit reasy food by is consistent with this stdy . he association between sociodemoraphic data and postpartm physica practice has been epored in this stdy as we. here was ony a sinificant association between ae and body scrb. aority of the respondents in this stdy were to years od. hs they are iey to concern more on their sincare as yon women are ery particar abot their sin. his is becase they want to ensre there are no sin probems especiay after chidbirth. in chanes often occr drin prenancy nti after deiery de to physiooic chanes which can case seera sin probems sch as hyperpimentation and stretch mar . y practicin body scrb chances to hae those probems can be redced. he inredients in the scrb and mas prodcts can ie heathy smooth and radiant sin by eertin their effect throh absorbindirt remoin dead ces brihtenin the sin and improe bood circation . oweer the same stdy done in enan aaysia fond an opposite rest on association between sociodemoraphic data and postpartm physica practice . hey mentioned that there is a statisticay sinificant rest between association of socio demoraphic data and consmption of traditiona herbs as oder women are more iey to se or consme traditiona herbs. he difference of findin reardin association of socio demoraphic data and postpartm physica practice miht be de to the ecsion of women more than years od in this stdy which eads to no edery rop of the respondents.

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part from that famiy tradition was the most infenced factor of postpartm care practice in this commnity. he tradition that passes from eneration to eneration withot fai ensres the continity of postpartm care practice in each famiy. his findin was spported by the stdy done in anaore ndia which caimed that the ctra bacrond of the new mother infences their practice drin postpartm period . he stdies done in hina and ambodia aso hae simiar rest which the new mothers say that they are doin sch practices in order to respect the tradition and foowin the adice of the eders 3. oweer the opposite rest reardin this isse which the practice stem from sefbeief of the new mothers aso was reported. he factors that infencin the postpartm practice amon mothers depends on whether the mothers are the first chid mothers or mtiparos mothers . he first chid mothers tend to practice diienty de to ac of motherhood eperience and nowede. t seems that factors that infenced practice of postpartm care amon mothers are ery wide and rey on the standpoint of the mothers. rthermore the findin of this stdy showed that the famiy tradition has contribted the most to nowede of postpartm care amon mothers. he contination of postpartm care practice that oriinated from od eneration enhance the nowede of the mothers. aority of the famiies foow the beiefs and practices of their parents and randparents and adopt them becase their ancestors are more nowedeabe abot those practices . amiy that hae been enaed with certain postpartm care practices for decades wi ensre the practices are passed to their net enerations . hs their descendants wi aso eperience the benefits of the practices. Note that this study is very important in order to support government’s mission and ision as tabated in nited ations iennim eeopment oas ). One of the MDG’s goal is to improve by 2015 . his oa shod not be oerstated becase one of the most eadin cases of death for adoescent irs is compications drin prenancy or chidbirth. oweer most materna deaths in deeopin contries are preentabe by receiin a proper heath care and adeate ntrition. n addition ood postpartum care is not only can save mother’s lives but their babies too Consequently, improin materna heath can be the ey to achiee which is to redce chid mortaity. t can be seen that this stdy can hep to achiee not st one bt two of the MDG’s goals which are improving maternal health and reducing child mortality. ence by condctin this stdy the beneficia nowede abot postpartm care can be disseminated to the mothers to epand their eistin nowede. onseenty they wod be abe to distinish between ood and bad in order to mae sre their heath are assred. oreer the ood postpartm care practices can be encoraed amon mothers particary those that can redce the compications drin confinement. he redction of postpartm compications can indirecty redce the nmber of deaths amon the mothers. ence this stdy can contribte to the achieement of the ision and mission of the oernment.

5 Conclusion n concsion nowede of postpartm care amon mothers in antan was ood and the practice was preaent amon them. his stdy indicated that sociodemoraphic data hae infenced certain postpartm dietary practice and postpartm physica practice. oreoer this stdy fond that the most important factor that infenced both postpartm care practice and nowede was famiy tradition. or recommendation mothers shod be eposed to the possibiity of compications de to etreme practice of postpartm care. herefore the harmf practice can be aoided. part from that this stdy can be sed as a

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oundation to conduct a study among multiracial population. he study would yield interesting results based on racial points o view.

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