Birthing practices in Sri Lanka

I chose to research and learn more about birthing practices in Sri Lanka. As a child growing up in Sri Lanka, I was shielded from discussions surrounding topics such as sex, pregnancy and childbirth. This is probably the reason why I feel like I don’t know much about the birthing practices in the country and chose to research this topic further. To give a little background; Sri Lanka is a small island nation located off the southeast coast of India. It has a diverse population of many ethnicities, religions and languages. Religion plays a role in beliefs and practices surrounding pregnancy and childbirth. The population is also diverse in its socio-economic status. As a developing nation faced with conflict until recent years, the level of development throughout the country varies which affects access to facilities, quality of life etc.

Throughout the country, pregnancy is considered a very special time in a marriage. In the Buddhist faith, couples perform rituals and make vows at Buddhist temples to ensure healthy pregnancy and safe delivery. A pregnant woman is well cared for by her family and her community and lavished with attention. The elder women in the family and community advise her on various aspects of the pregnancy. They make sure the mother to be is well fed by preparing whatever food she mother craves. However, there are many beliefs surrounding which foods should be eaten and which should be avoided during the pregnancy. For example pineapple, specific types of fish are avoided in the belief that they produce excess body heat that might cause an early abortion. Certain types of food are believed to augment breast milk production and women are also encouraged increase their intake of these types of food. Regardless of economic status, pregnant women try as much as possible to consume a healthy diet in the hope of giving birth to a healthy baby. However, economic constraints often prevent pregnant mothers from receiving the nutrition they need. They also hold widespread beliefs surrounding pregnancy and the supernatural. For example women are asked to avoid sewing shut stuffed pillowcase, tightening knots, striking nails all in the belief that it would hurt the baby. Baby showers are considered bad luck and gifts are not given until after the birth of the child. When preparing clothes for the baby, the garments are not completed until the birth because it assumes the birth is a certainty. 

Every area has a Medical Officer of Health (MOH) and a Public Health Midwife (PHM). Pregnant women register with the PHM during the first trimester and receive prenatal care through health clinics as well as home visits. In urban areas, there is increasing access to private hospitals as well as more doctors. Many in these areas opt for private medical facilities versus government provided health care because of better facilities and easier access but it comes at a price. 

It was customary for the pregnant woman to return to her mother’s house for the birth. Although this practice has diminished with modernization, the mother or a female relative steps into provide assistance to the mother to be. During this time, in the Buddhist faith, monks are invited to chant and cast away any evil spirits that may harm the mother and the fetus. The majority of births are assisted by physicians and take place in government health institutions but there is an increase in the use of private hospital facilities. Most women give birth vaginally but c-sections are on the rise. The availability and use of drugs to assist in the labor varies depending on the area. Rural areas have lesser facilities whereas urban areas have access to far better facilities. 

My sister-in-law in Sri Lanka chose to give birth in a government hospital due to the high cost of private hospitals. When she entered the hospital when she went into labor, she barely had a bed to lie on because the maternity ward was overcrowded. Her family including her husband had no way of knowing the progress of her labor. When she was ready to deliver, she was transferred to a labor room where she gave birth on her own surrounded only by her doctor and hospital staff during the late evening after hospital visiting hours. Her husband was not able to see her and the baby until the next morning. After the birth, her health and the baby’s health were monitored and the nursing staff instructed her on how to care for herself postpartum and the newborn. For these reasons, women who are able to afford it, opt to give birth in a private hospital. 

I was very saddened to hear about this experience in comparison to my own. The lack of facilities made the process seem a very impersonal one. In contrast, my husband was by side throughout my labor and delivery. I was in a comfortable hospital room and felt supported throughout. I believe that the birth process in Sri Lanka may cause emotional stress to the mother which might affect the delivery, possibly even resulting in complications.  The mother and the infant don’t seem to receive the attention and support they need which can affect the mother’s emotional health which will affect her ability to care for her newborn. My sister-in-law dealt with some emotional issues postpartum but was able to overcome through support from family. There is also no opportunity to bond as a family which I believe has an impact on a child’s development. Although, there is much to be desired about the facilities available in the area of maternal care in Sri Lanka, support from family and the community to the mother and the infant allow them to both thrive during the prenatal period and in the weeks and months following the birth. Despite his mother’s birth experience, my little nephew is now a very happy 3 year old developing well in all areas.