Cultural Competency and Haitian Immigrants


Pregnancy and Childbearing Practices

Purnell's Model

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Family roles & organization
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Workforce issues

Biocultural ecology

High-risk behaviors

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Death rituals

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Health care practices
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Health care practitioners




  • Haitians correlate pregnancy with intercourse and insemination.44, 46 Contraceptive use is not common and Haitian men are generally not willing to use contraceptives.42  The fertility rate in Haiti, as of 2002, is 4.3 infants per woman.14 One reason for the high fertility rate is the fatalist attitude that many Haitians adopt. They believe that certain health related conditions, including pregnancy,  are determined only by God.29, 46

  • Pregnancy is not seen as an illness and is a happy time for the whole family.29, 30

  • Traditionally in Haiti, babies are born at home with the aid of midwives. These midwives are not necessarily medically trained, but most likely were born into the profession.56

  •  Pregnancy does not relieve a woman from work 29, 30  nor does it require medical visits, thus prenatal care is not traditionally sought.15, 29, 30, 55, 56 However in one study subjects revealed that they thought prenatal care was important.44

  • Diet when pregnant is somewhat restrictive. Women are cautioned against eating spicy foods because they are thought to irritate the child.29, 30, 31, 32, 44 Women are encouraged to eat red fruits and vegetables (like beets and pomegranates) because they are believed to build up the fetus' blood. They are also encouraged to eat heartily since they are eating for two.26, 29, 30, 31, 32 See childbearing women and food preferences. 

  • Enemies are believed to have the capacity to put bad spells on the baby, therefore there are no dangers associated with pregnancy as long as the woman has no enemies.44

  • There are no restrictions on sexual activity during pregnancy.44
  • Haitian women may deal with the excess salivation brought on by pregnancy differently than Americans are used to. These women may carry a spit cup around with them since they do not feel they should swallow their saliva and do not feel this is at all inappropriate.29, 30

  • Labor practices of the Haitian woman may consist of walking, squatting, massaging the belly, and sitting. Haitian women tend not to ask for pain medication. It is not uncommon for some women to be loud and emotional, where others may be quiet and stoic. Fathers are usually not involved as labor is considered woman's work, and best handled by female friends and family members.29

  • After the birth of the baby the mother and the baby are often kept in confinement for about a month, during which both the mother and the infant are considered vulnerable to illness. Often, the family waits to name the infant until after the seclusion period has ended. Sometimes the baby may wear beads or necklaces to ward off evil spirits.38  

  • Some infants may wear a band of cloth around the abdomen to help them develop a strong body.55

  • It is believed that Mother and infant need to keep warm to prevent themselves from getting ill.26, 29, 38, 55

  • One postpartal procedure that is frequently used is the "three baths". Special herbs are gathered and water is made from it to bathe in, and  a tea made to drink. For the first three postpartum days the woman is encouraged to take a hot bath in the herb fortified water; this is the first bath. The next three days she is encouraged to bathe in herb fortified water that is warmed by the sun; this is the second bath . When the baby reaches the age of 1 month, the mother is encouraged to take the third, cold, bath. This last bath is thought to help healing and tighten the joints and muscles that were loosened by delivery.1529, 30, 55, 57

  • A woman is considered to be especially vulnerable to gas entering the body in the postpartum period. Thus, she must tighten her waist with a belt, a sash or a binder. This is also thought to help tighten her bones.29, 30, 55

  • Dietary restrictions are important during the postpartum phase (see nutrition section).

  • Breastfeeding is the norm in Haiti. However, health care practitioners have been alarmed at the lower rates of breast feeding practiced by Haitians in America. The increase in formula feeding has been related to socioeconomic factors including mother's need to work outside the household.36, 41, 42, 43

  • Haitian women have many concerns about breast-feeding and believe that breast-feeding causes some infant illnesses including intestinal parasites, diarrhea, or tetanus. If the milk is too thick, it is said to cause impetigo; if its too thin (caused by maternal fright or worry) it can cause maternal headaches, depression,  infant diarrhea, or even failure to thrive.26, 29, 30, 31, 41, 43, 58  If the mother becomes very upset it can cause "spoiled milk syndrome" which is irreversible and can poison the infant.43  Because of these beliefs, if the infant gets diarrhea, the breastfeeding is immediately ceased.

  • It is common for Haitian women to mix starchy additives to formula to encourage weight gain.36 

  • Another practice common to Haitians is to withhold food from the infant until the meconium is passed. In addition, it is believed that the first stool blocks the intestines and must be purged by giving the infant a lok which has castor oil as its main ingredient.36, 41, 44, 55  

Copyright  2003