FOOD HABITS AND PRACTICES DURING THE POSTPARTUM PERIOD AMONG SAUDI WOMEN ...

105 Pages·2014·1.05 MB·English

by  نجلاء عسيلان

FOOD HABITS AND PRACTICES DURING THE POSTPARTUM PERIOD
AMONG SAUDI WOMEN VS AMERICAN WOMEN

A thesis submitted to the
Kent State University College
of Education, Health, and Human Services
in partial fulfillment of the requirements
for the degree of Master of Science

By

Najlaa Y. Osailan

December 2014
©Copyright, 2014 by Najlaa Y. Osailan

All Rights Reserved
ii
A thesis written by
Najlaa Osailan
B.S., College of Education for Preparing Female Teachers, 2006
M.S., Kent State University, 2014

Approved by
_________________________, Director, Master’s Thesis Committee
Karen Lowry Gordon

_________________________, Member, Master’s Thesis Committee
Natalie Caine-Bish

_________________________, Member, Master’s Thesis Committee
Tanya Falcone

Accepted by
_________________________, Director, School of Health Sciences
Lynne Rowan

_________________________, Dean, College of Education, Health and Human Services
Daniel F. Mahony
iii
OSAILAN, NAJLAA Y., M. S. December, 2014 Education, Health and
Human Services

FOOD HABITS AND PRACTICES DURING THE POSTPARTUM PERIOD AMONG
SAUDI WOMEN VS AMERICAN WOMEN (97 pp.)

Director of Thesis: Karen Lowry Gordon, Ph.D.

The purpose of this study was to examine the difference between Saudi women
and American women living in United States, concerning their maternal dietary
restrictions and practices during the postpartum period. A survey was distributed
electronically to Saudi and American females who delivered a live birth during 2014 and
live in United States. There were 28 participants in this study. Statistical analysis
included descriptive, frequency, and comparative statistics. A Chi- Square (Ӽ2) test was
used to compare Saudi postpartum women versus American postpartum women. This
research study found that there was no significant association between groups with regard
to maternal dietary restrictions and traditional practices. These finding suggested that
both groups tended not to restrict or use special diet after the child birth, as well as not to
restrict their physical activity. However, this study also found that Ӽ2 analysis showed a
significant association among American postpartum women versus Saudi postpartum
women (P=0.049) with respect to attempting to lose weight during this period. This
indicates that some women might use some dietary restriction to enhance weight loss in
the postpartum period. Identifying the restrictions associated with traditional postpartum
practices is critical to develop better understanding to the cultural values and targeting
health education programs to increase healthcare providers’ cultural awareness and their
possibilities to provide culturally congruent care.
ACKNOWLEDGEMENTS
First and foremost, I would like to express my special appreciation and thanks to
my advisor Dr. Karen Lowry Gordon, you have been a tremendous mentor for me. I
would like to thank you for encouraging my research and for allowing me to grow as a
research scientist. Your advice on my thesis have been priceless. I would also like to
thank my committee members, Dr. Natalie Caine- Bish, and Mrs. Tanya Falcone for
serving as my committee members. Your support and expert input and comments were
very helpful and appreciated.
A special thanks to my family. Words cannot express how grateful I am to my
mother, and father for all of the sacrifices that you’ve made on my behalf. Your prayer
for me was what sustained me thus far. Next, I would like to thank my daughters:
Shahad, Joud, and Layan for their endless love, patience, and support. I would also like to
thank all of my friends who supported me in writing, and incented me to strive towards
my goal. At the end I would like to express appreciation to my beloved husband Khalid
Alshami who spent sleepless nights with, and was always my support in the moments
when there was no one to answer my queries.
iv
TABLE OF CONTENTS

ACKNOWLEDGEMENTS ............................................................................................... iv

LIST OF TABLES ............................................................................................................ vii

CHAPTER Page

I INTRODUCTION ......................................................................................................1
Statement of the Problem ...........................................................................................2
The Purpose of the Study ............................................................................................3
Research Hypotheses ..................................................................................................3
Operational Definitions ...............................................................................................3

II REVIEW OF LITERATURE ....................................................................................6
Defining the Postpartum Period .................................................................................6
Maternal Nutrition .....................................................................................................7
Energy Intake .......................................................................................................7
Protein and Calcium ..............................................................................................8
Iron ........................................................................................................................8
Fluid Intake ..........................................................................................................8
Alcohol and Caffeine ...........................................................................................9
Fish Consumption ................................................................................................9
Vitamins .............................................................................................................10
Physical Changes during Postpartum........................................................................12
Breastfeeding (Initiation of Milk Secretion) .......................................................12
Weight Changes .................................................................................................13
Bone Mineral Density (BMD) Changes ............................................................13
Hormonal Changes .............................................................................................14
Skin Changes .....................................................................................................15
Psychological Changes during Postpartum Period ...................................................16
Emotional Changes ............................................................................................18
Frequency and Nature of Health Problems during Postpartum ................................19
Infections.............................................................................................................19
Bladder Problems ................................................................................................21
Backache .............................................................................................................22
Frequent Headaches ............................................................................................23
Constipation ........................................................................................................23
Breast Problem ....................................................................................................24
Anemia ................................................................................................................25

v
TABLE OF CONTENTS (Continued)

Chapter Page

Hemorrhage.........................................................................................................25
Effect of Poor Diet during Postpartum Period .........................................................26
Effect on Mothers ..............................................................................................26
Effect on New Born ...........................................................................................26
Dietary Intake in American Postpartum Women .....................................................27
Dietary Intake in Saudi Arabian Postpartum Women ..............................................29
General Information about Saudi Arabia ...........................................................29
Health Custom during Postpartum among Saudi Women ..................................29
Postpartum Diet in Saudi Arabia ........................................................................30
Cultural Beliefs ..................................................................................................32
The Function of the Foods ..................................................................................32

III METHODOLOGY ...................................................................................................39
Research Design........................................................................................................39
Study Population ......................................................................................................39
Data Collection Instruments .....................................................................................40
Procedure ..................................................................................................................41
Statistical Analysis ....................................................................................................42

IV JOURNAL ARTICLE ..............................................................................................44
Introduction ...............................................................................................................44
Methods.....................................................................................................................46
Study Population ................................................................................................46
Data Collection Instruments ..............................................................................46
Procedure ............................................................................................................48
Statistical Analysis ..............................................................................................49
Results .......................................................................................................................49
Discussion ...........................................................................................................55
Application ..........................................................................................................58
Limitations ..........................................................................................................59
Conclusion .........................................................................................................60

APPENDICES ...................................................................................................................62
APPENDIX A. SURVEY ........................................................................................63
APPENDIX B. EMAIL INVITATION ...................................................................75
APPENDIX C. HANDOUT ....................................................................................77
APPENDIX D. CONSENT FORM ........................................................................79

REFERENCES ..................................................................................................................82
vi
LIST OF TABLES

Table Page

1 Practices and Beliefs during the Postpartum Period among
Different Cultures .......................................................................................................4

2 Comparison between Dietary Intake in Adult Women and Lactation ......................11

3 Timing of Onset, Symptom, and Incidence of Maternal Psychological
Problems ...................................................................................................................20

4 Recommendation for Postpartum Women in Saudi Arabia .....................................31

5 Demographic Data of Saudi and American Postpartum Women .............................51

6 Significant Association of Food Restrictions and Practices during the
Postpartum Period among Saudi vs American Women ...........................................52

vii
CHAPTER I

INTRODUCTION
The Postpartum period is the state of physiological stress characterized by
profound metabolic and hormonal changes. This period is the time of transition for
women and their families (Geneva, 1984). Mothers during this time undergo a lot of
pressure and concern about how they can get their health and shape back after childbirth,
which in some situations may cause psychological problems or disorders. Therefore,
women need to receive special health and social support during this time to prevent such
problems. Inadequate care might result in complications for the mother and her child.
Nutrition plays an important role in the course of the postpartum period. It is well
documented that dietary modification during this period has a profound effect on the
nutritional status of both the mother and the newborn (Geneva, 1984).
During this period, culture plays a major role in the way a woman perceives and
prepares for her birthing experience (Al-Kanhal & Bani, 1995). In fact, the notions of
birth and postnatal care vary considerably with cultural beliefs and traditional practices.
Each culture has its own values, beliefs and practices related to pregnancy and birth.
According to recent studies, eating habits after delivery among American women are not
very complex. Women simply continue to eat a good quality diet similar to the diet that
they used to consume during pregnancy. In contrast, in the Saudi culture, a postpartum
female is treated as a sick patient for the first six weeks after her childbirth. A long list of
food restrictions and work limitations is typically enforced on her (Piperata, 2008). For
1
2

instance, a Saudi postpartum woman is not supposed to consume certain types of food
such as cold foods and drinks. Also, new mothers are encouraged to consume more meat
and hot soups, as well as dates and herbal supplementations (Hundt, Beckerleg, Kassem,
Abu Jafar, Belmaker, Abu Saad & Vardi, 2000).
Statement of the Problem
The Post-partum period is a very stressful period for women worldwide due to the
changes that occur during this time, such as life, physical, and emotional changes as well
as some of the common problems encountered during this period. Approximately, 1,400
women die every day during postnatal period from complications related to childbirth
results in 500,000 death /year (Veneman AN, 2008). Therefore, the information on food
habits and beliefs during the reproductive period helps in assessing the causes and the
magnitude of those complications and in planning of the intervention programs.
Recently, Saudi families have come to the United States in large numbers to
pursue academic studies. Saudi Arabia's oil wealth allows the government to sponsor
these students financially. Consequently, the number of Saudi women who gave birth in
the United States is increasing. Some of these women follow the same food restrictions
that they used to follow in Saudi Arabia, while others follow the kind of restrictions that
are common in the United States because they either do not have access to the types of
foods that they used to eat during this time, or they do not have enough support to help
with their needs as well as that they have eventful times that are filled with much
studying and working. Therefore, the health care policy makers and health care providers
need to be cognizant of food restrictions and practices among those population which