Birth in Thailand
Encyclopedia
This article documents traditional and some modern childbirth
practices in Thailand
. Traditional beliefs are largely influenced by the folk beliefs in Central
and North Thailand, and modern practices by the western medical model.
in 1932. September 2006 military coup succeeded in expelling then Prime Minister Thaksin Chinnawat, but his party - People's Power Party
(PPP) – became the head of the coalition and took office in February 2008. In the May of 2008, there were massive demonstrations by the anti-Thaksin People's Alliance for Democracy
(PAD; yellow-shirts). After the dissolution of the PPP by the court ruling, Abhisit Wetchachiwa took the office of the Prime Minister. Since then, United Front for Democracy Against Dictatorship (UDD; red-shirts), a pro-Thaksin movement was formed, and organized protests in March through May 2010. Confrontations between the authorities and armed protesters resulted in “at least 92 deaths and an estimated $1.5 billion in arson-related property losses.”
(75%), 14% as Chinese
, and 11% as other nationalities. The main language is Thai, but there are regional dialects, and most educated people know English. A large majority (92.6%) of the population is considered literate.
Depending on the status of the person, (determined by age, occupation, wage, education, and social connections), different greeting wai
and language is used, that would mirror the superior-inferior rankings between the two.
The demography of Thailand has changed since the 1970s, mostly because of the promotion of small family sizes with the help of the family planning outreach programs and efforts of Mechai Viravaidya
. The current fertility rate is 1.66 children born per woman, which is low compared to the rest of Asia.
(or Phumiphon Adunyadet) is a chief of state, and has been on the throne since June 9, 1946. He and the rest of the Royal Family are deeply revered by the Thai people. The current Prime Minister and the chief of government is Abhisit Wechachiwa. These two are parts of the executive branch, which also includes three Deputy Prime Ministers and the Council of Ministers. There are also the Legislative and the Judicious branches.
Thailand’s major industries include: tourism
, textiles and garments, agricultural processing, beverages, tobacco, cement, jewelry and electric appliances, computers and parts, integrated circuits, furniture, plastics, automobiles and automotive parts, tungsten, and tin. The major agricultural products include: rice, cassava (tapioca), rubber, corn, sugarcane, coconuts, and soybeans.
, and 0.1% as other. There are also many folk beliefs that involve spirits, myths, use of charms and spells, days for doing certain things, and many others. Religious merit is sought after to improve one’s karma
.
on the east, and Malaysia in the south. The climate is tropical: rainy, warm, and cloudy mid-May to September, and dry and cool November to mid-March); it is always hot and humid on the southern isthmus.
, herbalism
(including dietary regimen), and spiritual or religious healing. The three branches are used to balance each of the essences. For example, there are ten tastes of foods and herbs that are recognized by the Thai medicine, and taste opposite of the disease process would be used to treat it. Similarly, the four elements of the body (Fire, Water, Air, and Earth) must be kept in balance by eating certain foods.
(27.8%), sepsis (8.73%), toxemia (16.7%), amniotic fluid embolism (11.9%), and other causes (8.73%) (2003).
A high percentage of laboring women (97%) are attended by skilled health personnel, which is much higher than the regional average (49%) (2008). Women in Thailand are also much likely to attend 4 or more antenatal visits (74%) compared to women in other countries in South-East Asia (43%) and use conception (81% compared to 58%) (2008).
Under-5 mortality rate (per 1000 live births) has decreased to 14 (2008) from 28 (2002). Infant mortality has also decreased from 20 (2002) to 16.39 deaths per 1000 births (2011).
beliefs, conception
occurs when a khwan (soul) flies into the womb during a sexual encounter. A woman whose period stops and who starts craving sour foods is thought to be pregnant. Once a woman finds out she is pregnant, she is to tell her partner first, followed by her mother and her mother in law. Infertility
is seen as imbalance in one of the essences. Certain acupressure points, however, could be utilized to resolve the issue.
Abortion
s are seen by Buddhists as “as impeding an individual's rebirth and disobeying a religious prohibition on taking life,” and they are currently illegal in Thailand. Only in the following three cases it is allowed: (1) if mother’s life is in danger, (2) if mother’s physical or mental health is at risk, and (3) if the pregnancy is a result of an offense or seduction of a girl under 15. However, about two thirds of women seek help outside of the main healthcare system to terminate the unplanned pregnancy, and 12% attempt to do it themselves.
, young coconut meat, salty foods, tamarind, fish, garlic, onion, and warm liquids. Those who consume pak plang, a slippery vine-like green vegetable, would have an easy birth, since it will make the baby’s body slippery. Ya tom herbal medicine could be prepared as tea and would make the baby strong and easy to deliver if the pregnant woman drinks the tea three times a day for three consecutive days.
However, khong salaeng (allergic foodstuff) must be avoided by pregnant women, since it may cause unwanted problems during labor or for the unborn child. Khong salaeng foods include papaya salad, pickled food, spicy hot food (baby may be born hairless), coffee and tea (baby will be not intelligent), shellfish (prevents perineum from drying after delivery), and Thai eggplants (may cause anal pain after delivery). Women are also advised to eat only half a banana, since birth may become obstructed if she eats a whole banana.
or stillbirth
, however this may sometimes be unavoidable by the rural poor. Regular activity, however, would promote easy birth by making the abdomen ‘loose’ (tong klon) and therefore aiding in the downward head rotation of the baby. Idleness and frequent resting, on the other hand, would complicate birth. There is no available information on the importance of sleep in pregnancy.
There are accounts that sexual activity was promoted during pregnancy in Central Thailand since sperm would make the baby strong, however, in the Northern parts of Thailand it is seen as a form of vigorous activity that may result in miscarriage. Although pregnant women are prohibited from attending a funeral, wearing a brooch on the abdomen would counteract any negative effects on the fetus. Women should also not make any advanced preparations, such as buying or making baby clothes, as this may result the death of the baby. Other pregnancy-related beliefs include not sitting in the stairway (causes obstructed birth), not burying anything in the soil (difficult birth), and having magical showers (to promote easy delivery and emotional calmness). These showers should be “blessed with sacred words known as ‘nam mon’ by mor mon (a magical healer, or even a monk); they are usually done in an open-aired space from eighth to ninth month of pregnancy. During the last weeks of normal pregnancy, a woman may choose to go to a masseuse for “lifting of a uterus (yok thong) to increase comfort.”
are available at most pharmacies; pregnancy could also be confirmed at a gynecologist’s office using blood and urine tests. Currently, pregnant women are required to attend at least four antenatal care visits. Normal pregnancies would be managed by gynecological nurses or midwives, while high-risk pregnancies must be monitored by obstetricians. Ideally, a woman would attend antenatal check-ups “every month until 28 weeks of gestation, then every fortnight from 28–32 weeks and every week after 32 weeks,” however, the number of visits will depend on the woman and her healthcare providers. In Thailand, antenatal care is free in the public health services sector. There is a private and public sector in healthcare, the latter provided by the Ministry of Public Health and teaching hospitals. In the 2005 study by Liamputtong et al., women of Chiang Mai
(Northern Thailand) revealed that they “only incorporate cultural knowledge when it is practicable and suitable to their daily living situations.”
The traditional delivery assistant, who is usually a woman, is called 'Mo Tamaye' in the Central Thailand and Mae Jang in the North. It is generally accepted that the labor starts when the waters break. If the family cannot get to the nearest medical facility, or does not want to, Mo Tamaye is called. Usually, the husband and Mo Tamaye are present during deliver, but relatives and children may attend as well; however, the woman in labor must be covered from the waist to knee.
. In one, a folded mattress would be supporting a woman’s back while her husband would provide support sitting behind her and letting grab onto his thighs. There would be feet supports made out of bamboo that a woman can push on during contractions. In another position, a woman would be sitting, with Mo Tamaye supporting her from behind, and would pull on a rope that is hanging from the ceiling to alleviate some pain. The woman must take an active role in the process by breathing and pushing with contractions, with the help of Mo Tamaye. In a medical setting, a woman would most likely have limited options for positions and would be laid flat on the bed to deliver. Culturally, there is no need to keep silent during the birthing process, but pain management is available in most clinics. There is no data regarding the use of fetal monitoring; however, it is likely used in the westernized hospital settings, which would limit woman’s mobility during labor. Samitiyei Hospital is currently the only hospital is the country that offers natural and water birth
.
is performed should the complications arise. However, the rate of C-sections has been increasing globally, which may be due to financial incentives. Thailand is no exception, with rates rising from 15.2% (1990) to 22.4% (1996) to 34% (2007). A study in 2000 concluded that “private cases have a 5.83 higher chance of primary cesarean section than non-private cases” because “physicians feel obliged to provide personal delivery services, when triggered by leisure and time conflict, [which] leads to higher and possibly unnecessary cesarean procedures.”
Traditionally, it would be the woman who would be choosing the provider and working closely with her to carry out the birth in a desired manner. It is not always possible today, especially in the modernized hospitals, where a woman would be subject to the system regulations.
three times away from the baby “to remove dirt,” then push it back, tie the cord in two places with a special cotton string, and cut the cord in between the two fastened places. The cut cord is then burned, and placenta
is buried, usually by the father. (Traditions)
. A woman’s diet must consist of rice and vegetables in the first few months after pregnancy; meat, with exception of fish, must be avoided. From a Traditional Thai Medicine perspective, “sour tastes [do] not dry out the body, but built up water; egg [is] too cooling; jackfruit [brings] in wind [air]; glutinous rice and the sugar of sweets wet the uterus; fruits [do] not give strength and [are] excessively cooling.” Teas out of herbs (naam puu loey) should be consumed, and showers with herbal water (naam puu loeyand naam bai paw) should be taken daily without washing hair the first two weeks.
Nothing in particular was mentioned about sleep and wakefulness, rest, emotional behavior, or sexual activity as pertaining to the postpartum period.
Another tradition includes making offerings at a temple (wat
) on the third day after the baby is born to obtain a blessing from a monk
. Fire-Shaving ceremony takes place when the child reaches the age of one month and one day, which involves cutting of the baby’s hair. As a precaution, babies must be kept away from the rain. Circumcision
is not very prevalent in Thailand; only 13% of Thai male population are circumcised.
It is not specified when the newborn period ends. There is also no information on the significance of vernix, the baby’s rest, activity, and movement, as well as meconium
and handling of the urine and feces.
. While some view twins as needing more resources and being too demanding on a family, others see having twins as lucky, since it is convenient to take care of them at the same time.
Childbirth
Childbirth is the culmination of a human pregnancy or gestation period with the birth of one or more newborn infants from a woman's uterus...
practices in Thailand
Thailand
Thailand , officially the Kingdom of Thailand , formerly known as Siam , is a country located at the centre of the Indochina peninsula and Southeast Asia. It is bordered to the north by Burma and Laos, to the east by Laos and Cambodia, to the south by the Gulf of Thailand and Malaysia, and to the...
. Traditional beliefs are largely influenced by the folk beliefs in Central
Central Thailand
Central Thailand is a region of Thailand, covering the broad alluvial plain of the Chao Phraya River. It is separated from North-East Thailand by the Phetchabun mountain range, and another mountain range separates it from Myanmar to the west. In the north it gently changes into the more hilly...
and North Thailand, and modern practices by the western medical model.
History
Thailand kingdom was established in the mid-14th century, and converted to a constitutional monarchyConstitutional monarchy
Constitutional monarchy is a form of government in which a monarch acts as head of state within the parameters of a constitution, whether it be a written, uncodified or blended constitution...
in 1932. September 2006 military coup succeeded in expelling then Prime Minister Thaksin Chinnawat, but his party - People's Power Party
People's Power Party
People's Power Party can refer to:* Lok Janshakti Party * People's Power Party * People’s Power party...
(PPP) – became the head of the coalition and took office in February 2008. In the May of 2008, there were massive demonstrations by the anti-Thaksin People's Alliance for Democracy
People's Alliance for Democracy
The People's Alliance for Democracy also called the National Liberation Alliance - กลุ่มพันธมิตรกู้ชาติ, Thai Patriots Network or the Yellow Shirts - เสื้อเหลือง - was originally a coalition of protesters against Thaksin Shinawatra, the former Prime Minister of Thailand. Its leaders include...
(PAD; yellow-shirts). After the dissolution of the PPP by the court ruling, Abhisit Wetchachiwa took the office of the Prime Minister. Since then, United Front for Democracy Against Dictatorship (UDD; red-shirts), a pro-Thaksin movement was formed, and organized protests in March through May 2010. Confrontations between the authorities and armed protesters resulted in “at least 92 deaths and an estimated $1.5 billion in arson-related property losses.”
Social Structure and Organization
Thailand has a population of 66,720,153, 34% of whom live in an urban setting, and 9.6% of whom live below the poverty line. Three quarters identify themselves as ThaiThai people
The Thai people, or Siamese, are the main ethnic group of Thailand and are part of the larger Tai ethnolinguistic peoples found in Thailand and adjacent countries in Southeast Asia as well as southern China. Their language is the Thai language, which is classified as part of the Kradai family of...
(75%), 14% as Chinese
Chinese people
The term Chinese people may refer to any of the following:*People with Han Chinese ethnicity ....
, and 11% as other nationalities. The main language is Thai, but there are regional dialects, and most educated people know English. A large majority (92.6%) of the population is considered literate.
Depending on the status of the person, (determined by age, occupation, wage, education, and social connections), different greeting wai
Thai greeting
The Thai greeting referred to as the wai consists of a slight bow, with the palms pressed together in a prayer-like fashion. It has its origin in the Indic Añjali Mudrā, like the Indian namasté and the Cambodian sampeah...
and language is used, that would mirror the superior-inferior rankings between the two.
The demography of Thailand has changed since the 1970s, mostly because of the promotion of small family sizes with the help of the family planning outreach programs and efforts of Mechai Viravaidya
Mechai Viravaidya
Mechai Viravaidya is a former politician and activist in Thailand who has popularized condoms in that country.Since the 1970s, Mechai has been affectionately known as "Mr...
. The current fertility rate is 1.66 children born per woman, which is low compared to the rest of Asia.
Political and Economic system
King Bhumibol AdulyadejBhumibol Adulyadej
Bhumibol Adulyadej is the current King of Thailand. He is known as Rama IX...
(or Phumiphon Adunyadet) is a chief of state, and has been on the throne since June 9, 1946. He and the rest of the Royal Family are deeply revered by the Thai people. The current Prime Minister and the chief of government is Abhisit Wechachiwa. These two are parts of the executive branch, which also includes three Deputy Prime Ministers and the Council of Ministers. There are also the Legislative and the Judicious branches.
Thailand’s major industries include: tourism
Tourism
Tourism is travel for recreational, leisure or business purposes. The World Tourism Organization defines tourists as people "traveling to and staying in places outside their usual environment for not more than one consecutive year for leisure, business and other purposes".Tourism has become a...
, textiles and garments, agricultural processing, beverages, tobacco, cement, jewelry and electric appliances, computers and parts, integrated circuits, furniture, plastics, automobiles and automotive parts, tungsten, and tin. The major agricultural products include: rice, cassava (tapioca), rubber, corn, sugarcane, coconuts, and soybeans.
Religion
A large majority of the population (94.6%) identifies themselves as Buddhist, 4.6% as Muslims, 0.7% as ChristianChristian
A Christian is a person who adheres to Christianity, an Abrahamic, monotheistic religion based on the life and teachings of Jesus of Nazareth as recorded in the Canonical gospels and the letters of the New Testament...
, and 0.1% as other. There are also many folk beliefs that involve spirits, myths, use of charms and spells, days for doing certain things, and many others. Religious merit is sought after to improve one’s karma
Karma
Karma in Indian religions is the concept of "action" or "deed", understood as that which causes the entire cycle of cause and effect originating in ancient India and treated in Hindu, Jain, Buddhist and Sikh philosophies....
.
Physical Environment
Thailand is located in the South-East Asia, and shares boarders with Myanmar (Burma) on the west, LaosLaos
Laos Lao: ສາທາລະນະລັດ ປະຊາທິປະໄຕ ປະຊາຊົນລາວ Sathalanalat Paxathipatai Paxaxon Lao, officially the Lao People's Democratic Republic, is a landlocked country in Southeast Asia, bordered by Burma and China to the northwest, Vietnam to the east, Cambodia to the south and Thailand to the west...
on the east, and Malaysia in the south. The climate is tropical: rainy, warm, and cloudy mid-May to September, and dry and cool November to mid-March); it is always hot and humid on the southern isthmus.
Health and Illness Theories
Traditional Thai Medicine is based on the mixed indigenous traditions of Indian, Chinese, and Khmer influences. Historically, Jivaka Kumar Bhaccha is considered the “Father Doctor” of Thai medicine. The “Circle of Life” is a central concept in Thai medicine philosophy, which involves the three essences of the human body that must be kept in balance to maintain health. The three essences are: (1) Energy (holds mind, body, and heart together, similar to qi/chi/prana), (2) Body (physical substance), and (3) Citta (mind/heart, non-physical being that holds all thoughts, emotions, spirit; inner self). Thai Traditional Medicine has three branches that correspond to the three essences: Thai massageThai massage
Thai massage is a type of massage in Thai style that involves stretching and deep massage. This form of bodywork is usually performed on the floor, and the client wears comfortable clothes that allow for movement. No oils are used in Thai massage...
, herbalism
Herbalism
Herbalism is a traditional medicinal or folk medicine practice based on the use of plants and plant extracts. Herbalism is also known as botanical medicine, medical herbalism, herbal medicine, herbology, herblore, and phytotherapy...
(including dietary regimen), and spiritual or religious healing. The three branches are used to balance each of the essences. For example, there are ten tastes of foods and herbs that are recognized by the Thai medicine, and taste opposite of the disease process would be used to treat it. Similarly, the four elements of the body (Fire, Water, Air, and Earth) must be kept in balance by eating certain foods.
Women’s Health Statistics
Women’s life expectancy at birth in Thailand is 76.08 years (71.24 for men). Two percent of the women smoke. The current (2011) birth rate is estimated to be 12.95 births per 1,000 population. Maternal mortality ratio is 20.63 per 100,000 live births, and the major causes of maternal death are hemorrhagePostpartum hemorrhage
Hemorrhage after delivery, or postpartum hemorrhage, is the loss of greater than 500 ml of blood following vaginal delivery, or 1000 ml of blood following cesarean section...
(27.8%), sepsis (8.73%), toxemia (16.7%), amniotic fluid embolism (11.9%), and other causes (8.73%) (2003).
A high percentage of laboring women (97%) are attended by skilled health personnel, which is much higher than the regional average (49%) (2008). Women in Thailand are also much likely to attend 4 or more antenatal visits (74%) compared to women in other countries in South-East Asia (43%) and use conception (81% compared to 58%) (2008).
Under-5 mortality rate (per 1000 live births) has decreased to 14 (2008) from 28 (2002). Infant mortality has also decreased from 20 (2002) to 16.39 deaths per 1000 births (2011).
Pregnancy Behaviors and Beliefs
There are many traditional beliefs associated with the way pregnancy should be carried out. According to the Central ThaiCentral Thailand
Central Thailand is a region of Thailand, covering the broad alluvial plain of the Chao Phraya River. It is separated from North-East Thailand by the Phetchabun mountain range, and another mountain range separates it from Myanmar to the west. In the north it gently changes into the more hilly...
beliefs, conception
Conception
Conception, or a concept, is an abstract idea or a mental symbol.Conception may also refer to:* Conception, or fertilisation, the fusion of gametes to produce a new organism.* Conception , an album by Miles Davis...
occurs when a khwan (soul) flies into the womb during a sexual encounter. A woman whose period stops and who starts craving sour foods is thought to be pregnant. Once a woman finds out she is pregnant, she is to tell her partner first, followed by her mother and her mother in law. Infertility
Infertility
Infertility primarily refers to the biological inability of a person to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term...
is seen as imbalance in one of the essences. Certain acupressure points, however, could be utilized to resolve the issue.
Abortion
Abortion
Abortion is defined as the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo prior to viability. An abortion can occur spontaneously, in which case it is usually called a miscarriage, or it can be purposely induced...
s are seen by Buddhists as “as impeding an individual's rebirth and disobeying a religious prohibition on taking life,” and they are currently illegal in Thailand. Only in the following three cases it is allowed: (1) if mother’s life is in danger, (2) if mother’s physical or mental health is at risk, and (3) if the pregnancy is a result of an offense or seduction of a girl under 15. However, about two thirds of women seek help outside of the main healthcare system to terminate the unplanned pregnancy, and 12% attempt to do it themselves.
Diet During Pregnancy
Since pregnancy is considered to be a ‘hot’ condition in Thai Medicine, foods to maintain warmth are preferred, such as ginger tea, coconut milkCoconut milk
Coconut milk is the water that comes from the grated meat of a coconut. The colour and rich taste of the milk can be attributed to the high oil content. In many parts of the world, the term coconut milk is also used to refer to coconut water, the naturally occurring liquid found inside the hollow...
, young coconut meat, salty foods, tamarind, fish, garlic, onion, and warm liquids. Those who consume pak plang, a slippery vine-like green vegetable, would have an easy birth, since it will make the baby’s body slippery. Ya tom herbal medicine could be prepared as tea and would make the baby strong and easy to deliver if the pregnant woman drinks the tea three times a day for three consecutive days.
However, khong salaeng (allergic foodstuff) must be avoided by pregnant women, since it may cause unwanted problems during labor or for the unborn child. Khong salaeng foods include papaya salad, pickled food, spicy hot food (baby may be born hairless), coffee and tea (baby will be not intelligent), shellfish (prevents perineum from drying after delivery), and Thai eggplants (may cause anal pain after delivery). Women are also advised to eat only half a banana, since birth may become obstructed if she eats a whole banana.
Behavior During Pregnancy
According to traditional beliefs, strenuous activities, such as heavy lifting, farm work, and even driving a car may lead to a miscarriageMiscarriage
Miscarriage or spontaneous abortion is the spontaneous end of a pregnancy at a stage where the embryo or fetus is incapable of surviving independently, generally defined in humans at prior to 20 weeks of gestation...
or stillbirth
Stillbirth
A stillbirth occurs when a fetus has died in the uterus. The Australian definition specifies that fetal death is termed a stillbirth after 20 weeks gestation or the fetus weighs more than . Once the fetus has died the mother still has contractions and remains undelivered. The term is often used in...
, however this may sometimes be unavoidable by the rural poor. Regular activity, however, would promote easy birth by making the abdomen ‘loose’ (tong klon) and therefore aiding in the downward head rotation of the baby. Idleness and frequent resting, on the other hand, would complicate birth. There is no available information on the importance of sleep in pregnancy.
There are accounts that sexual activity was promoted during pregnancy in Central Thailand since sperm would make the baby strong, however, in the Northern parts of Thailand it is seen as a form of vigorous activity that may result in miscarriage. Although pregnant women are prohibited from attending a funeral, wearing a brooch on the abdomen would counteract any negative effects on the fetus. Women should also not make any advanced preparations, such as buying or making baby clothes, as this may result the death of the baby. Other pregnancy-related beliefs include not sitting in the stairway (causes obstructed birth), not burying anything in the soil (difficult birth), and having magical showers (to promote easy delivery and emotional calmness). These showers should be “blessed with sacred words known as ‘nam mon’ by mor mon (a magical healer, or even a monk); they are usually done in an open-aired space from eighth to ninth month of pregnancy. During the last weeks of normal pregnancy, a woman may choose to go to a masseuse for “lifting of a uterus (yok thong) to increase comfort.”
Modern Pregnancy
Today, pregnancy test kitsPregnancy test
A pregnancy test attempts to determine whether or not a woman is pregnant.These markers are found in urine and blood, and pregnancy tests require sampling one of these substances. The first of these markers to be discovered, human chorionic gonadotropin , was discovered in 1930 to be produced by...
are available at most pharmacies; pregnancy could also be confirmed at a gynecologist’s office using blood and urine tests. Currently, pregnant women are required to attend at least four antenatal care visits. Normal pregnancies would be managed by gynecological nurses or midwives, while high-risk pregnancies must be monitored by obstetricians. Ideally, a woman would attend antenatal check-ups “every month until 28 weeks of gestation, then every fortnight from 28–32 weeks and every week after 32 weeks,” however, the number of visits will depend on the woman and her healthcare providers. In Thailand, antenatal care is free in the public health services sector. There is a private and public sector in healthcare, the latter provided by the Ministry of Public Health and teaching hospitals. In the 2005 study by Liamputtong et al., women of Chiang Mai
Chiang Mai
Chiang Mai sometimes written as "Chiengmai" or "Chiangmai", is the largest and most culturally significant city in northern Thailand. It is the capital of Chiang Mai Province , a former capital of the Kingdom of Lanna and was the tributary Kingdom of Chiang Mai from 1774 until 1939. It is...
(Northern Thailand) revealed that they “only incorporate cultural knowledge when it is practicable and suitable to their daily living situations.”
Setting
In 1960’s, 99% of the women in villages delivered at home. Today the number is much lower, as most Thai women give birth in hospitals and clinics, generally where they go for antenatal care. However, nowadays homebirths are becoming popular, but they may not be fully covered by insurance policies. Traditionally, Thai women would give birth at home, either in the bedroom or the kitchen. The delivery room at home is usually decorated with Yant Trinisinghé, “small flags inscribed with sacred numbers from one to nine” or with letters and sings; each flag is a “symbol of a long mantra passage, believed to have power to ward off evil spirits.” Buffalo leather could be used instead of the flags.Birth Assistant and Attendants
According to the WHO’s 2008 Thailand health profile, 99% of urban, 97% or rural, and 93% of the poorest 20% of women have their children delivered by skilled health persons, which is a much better compared to the regional average of 49%. As a part of the four-year curriculum, all nurses go through half a year of midwifery training, and may later choose to specialize. However, an obstetrician carries most responsibility during a birth in the hospitals It is unclear how the traditional delivery assistants are trained, but most likely through observational experiences.The traditional delivery assistant, who is usually a woman, is called 'Mo Tamaye' in the Central Thailand and Mae Jang in the North. It is generally accepted that the labor starts when the waters break. If the family cannot get to the nearest medical facility, or does not want to, Mo Tamaye is called. Usually, the husband and Mo Tamaye are present during deliver, but relatives and children may attend as well; however, the woman in labor must be covered from the waist to knee.
Birth Positions
There are variations in the traditional birthing positionsChildbirth positions
The term childbirth positions refers to the various physical postures the pregnant mother may assume during the process of childbirth...
. In one, a folded mattress would be supporting a woman’s back while her husband would provide support sitting behind her and letting grab onto his thighs. There would be feet supports made out of bamboo that a woman can push on during contractions. In another position, a woman would be sitting, with Mo Tamaye supporting her from behind, and would pull on a rope that is hanging from the ceiling to alleviate some pain. The woman must take an active role in the process by breathing and pushing with contractions, with the help of Mo Tamaye. In a medical setting, a woman would most likely have limited options for positions and would be laid flat on the bed to deliver. Culturally, there is no need to keep silent during the birthing process, but pain management is available in most clinics. There is no data regarding the use of fetal monitoring; however, it is likely used in the westernized hospital settings, which would limit woman’s mobility during labor. Samitiyei Hospital is currently the only hospital is the country that offers natural and water birth
Water birth
Water birth is a method of giving birth, which involves immersion in warm water. The immersion can mean giving birth to the infant in the water or using it as a tool during the labor process. Proponents believe that this method is safe and provides many benefits for both mother and infant,...
.
Traditions During Labor
In case of birth complications, the traditional birth assistant would give the woman some holy water or press on her belly. There were no specific foods mentioned to eat during labor. To promote an easy delivery, all windows and doors must be open and the woman must be facing East to symbolize the emergence of new life. The husband should also pile logs outside facing East. Any fastened nails must be undone, and no one should be punching nails to avoid stalled birth. To be born with an umbilical (holy) cord wrapped abound neck was considered a sign of fortune. Nothing in particular was mentioned about sleep and wakefulness, abnormalities, rest, emotional behavior, or sexual activity as pertaining to labor or birth.Caesarean Section
In the medical model of pregnancy, Caesarean sectionCaesarean section
A Caesarean section, is a surgical procedure in which one or more incisions are made through a mother's abdomen and uterus to deliver one or more babies, or, rarely, to remove a dead fetus...
is performed should the complications arise. However, the rate of C-sections has been increasing globally, which may be due to financial incentives. Thailand is no exception, with rates rising from 15.2% (1990) to 22.4% (1996) to 34% (2007). A study in 2000 concluded that “private cases have a 5.83 higher chance of primary cesarean section than non-private cases” because “physicians feel obliged to provide personal delivery services, when triggered by leisure and time conflict, [which] leads to higher and possibly unnecessary cesarean procedures.”
Traditionally, it would be the woman who would be choosing the provider and working closely with her to carry out the birth in a desired manner. It is not always possible today, especially in the modernized hospitals, where a woman would be subject to the system regulations.
Postpartum
The postpartum period begins right after the birth of the child, but it is not specified when it ends. It takes place at home following home birth, or in the hospital for 2–3 days and then at home following hospital birth.The Cord and Placenta
Following a traditional delivery, Mo Tamaye would milk the umbilical cordUmbilical cord
In placental mammals, the umbilical cord is the connecting cord from the developing embryo or fetus to the placenta...
three times away from the baby “to remove dirt,” then push it back, tie the cord in two places with a special cotton string, and cut the cord in between the two fastened places. The cut cord is then burned, and placenta
Placenta
The placenta is an organ that connects the developing fetus to the uterine wall to allow nutrient uptake, waste elimination, and gas exchange via the mother's blood supply. "True" placentas are a defining characteristic of eutherian or "placental" mammals, but are also found in some snakes and...
is buried, usually by the father. (Traditions)
Woman’s Rite of Passage
After a woman gives birth to her first child, she is considered an adult. She then undergoes the Jufaj when she must lay near fire for an odd number of days, usually around 11 days, so that her uterus will shrink back to the normal size. After each following births, the number of days spent near fire may be decreased. Also, a wooden box with a fire pot may be placed on the woman’s stomach to serve the same purpose. Fire is also said to scare off evil spirits, especially combined with the lemongrass aroma. After a Jufaj, a woman is allowed to move out of her parents’ residence, where she would live before and during the pregnancy, since she is now a mature adult.Postpartum Diet and Behavior
As with the pregnancy diet, warm foods are encouraged, such as hot curriesCurry
Curry is a generic description used throughout Western culture to describe a variety of dishes from Indian, Pakistani, Bangladeshi, Sri Lankan, Thai or other Southeast Asian cuisines...
. A woman’s diet must consist of rice and vegetables in the first few months after pregnancy; meat, with exception of fish, must be avoided. From a Traditional Thai Medicine perspective, “sour tastes [do] not dry out the body, but built up water; egg [is] too cooling; jackfruit [brings] in wind [air]; glutinous rice and the sugar of sweets wet the uterus; fruits [do] not give strength and [are] excessively cooling.” Teas out of herbs (naam puu loey) should be consumed, and showers with herbal water (naam puu loeyand naam bai paw) should be taken daily without washing hair the first two weeks.
Postnatal Care and Maternal Leave
Woman’s household duties would be taken care by the husband, female relatives, and older children. Traditionally, the female relatives would also check on the new mother; now in 4 to 8 weeks a woman must attend a health clinic for a check-up and to register her child’s birth. Labour Protection Act of 1998 guarantees women to have three months of maternity leave, to retain the job a woman had prior to pregnancy, and to temporary change duties with a doctor’s letter.Nothing in particular was mentioned about sleep and wakefulness, rest, emotional behavior, or sexual activity as pertaining to the postpartum period.
Traditional Rituals
There are many variations in traditions across Thailand. Central Thai people say the baby is tog fag (falls on bamboo) when he or she is born. After Mo Tamaye cuts the umbilical cord, she washes and beautifies the baby with yellow and white powder. On the third day after birth, Lon Dek Nai Kadon rite (translates to “rock the cradle in which a new born baby is sleeping”) is carried out. A baby is placed into a basket with a pencil and a notebook (for brightness), and money (for richness); girls are also given knives (to cut and comb hair) (Attagara 1968, p. 103) and cooking utensils. The basket with the baby and instruments is then handed over to “a respectable man in the village. This means that the baby became his adopted child temporarily, which reflects that the parents expect their baby to be rich and respectable like the adoptive.”Another tradition includes making offerings at a temple (wat
Wat
A wat is a monastery temple in Cambodia, Thailand, or Laos. The word "wat" means "school".- Introduction :...
) on the third day after the baby is born to obtain a blessing from a monk
Monk
A monk is a person who practices religious asceticism, living either alone or with any number of monks, while always maintaining some degree of physical separation from those not sharing the same purpose...
. Fire-Shaving ceremony takes place when the child reaches the age of one month and one day, which involves cutting of the baby’s hair. As a precaution, babies must be kept away from the rain. Circumcision
Circumcision
Male circumcision is the surgical removal of some or all of the foreskin from the penis. The word "circumcision" comes from Latin and ....
is not very prevalent in Thailand; only 13% of Thai male population are circumcised.
It is not specified when the newborn period ends. There is also no information on the significance of vernix, the baby’s rest, activity, and movement, as well as meconium
Meconium
Meconium is the earliest stools of an infant. Unlike later feces, meconium is composed of materials ingested during the time the infant spends in the uterus: intestinal epithelial cells, lanugo, mucus, amniotic fluid, bile, and water. Meconium is almost sterile, unlike later feces, is viscous and...
and handling of the urine and feces.
Care for the Baby
For the first month of the baby’s life, the mother must stay very close and “breastfeed the newborn on its slightest demand.” Babies are also sometimes given a mixture of banana, honey, and water to prevent diarrhea. If the baby cries too much and cannot sleep, it is believed that the baby’s guardian spirit, Mae Sue, is teasing the newborn too much. Usual interaction with Mae Sue is normal, during which the baby will play and laugh by itself.Naming
Traditionally, a name is given to the child on the forth or fifth day after birth by the father, however, there could have been variations across Thailand. Today, both mother and father can take part in deciding on a name. A child may not hold the same name as Royalty.Twins
There is a variation in the view of twinsTWINS
Two Wide-Angle Imaging Neutral-Atom Spectrometers are a pair of NASA instruments aboard two United States National Reconnaissance Office satellites in Molniya orbits. TWINS was designed to provide stereo images of the Earth's ring current. The first instrument, TWINS-1, was launched aboard USA-184...
. While some view twins as needing more resources and being too demanding on a family, others see having twins as lucky, since it is convenient to take care of them at the same time.