Join me in this amazing opportunity to learn about culturally competent maternity and postpartum care for Muslim women. Educator and postpartum mental health advocate Hajara Kutty shares invaluable religious and cultural context for birth and postpartum care in Islamic families. Part I of my interview discusses childbirth practices and ways to integrate cultural competence in childbirth education. Part II will cover postpartum care, including breastfeeding, and emotional support.

Walker: Can you describe some of the general cultural and religious guidelines surrounding labour and the birth of a baby in the Muslim culture?

Hajara: In the context of Islam, the birth of child (girl or boy) is a very joyous event; all children are seen as gifts from God.

In the Qur'an (Muslim Holy Book), childbirth and labour are recognized as extremely painful and taxing experiences. In the Qur'anic rendering of the story of the Mary mother of Jesus (a respected Prophet of God according to Islam), it quotes Mary as saying while in the throes of labour, "Ah! Would that I had died before this! Would that I had been a thing forgotten!"

The physical and emotional pain a mother endures during pregnancy, labour, delivery and postpartum is but one reason why Islam accords such an elevated status to mothers. In this regard, the Qur'an reminds people to, "Respect the womb that bore you." Additionally, some of the traditions and sayings of the Prophet in this regard include: that one owes to their mothers three times more love and obedience than that owed to one's father, and that "Paradise lies at the feet (serving the needs) of one's mother."

There are really no guidelines around labour, but as per the example set in the story of Mary, it is seen as a time to turn to God for comfort and assistance.

When it comes to the actual birth, there are a few important practices that need to be kept in mind. Upon the child actually entering the world, one of the first requirements is for the father to recite the adhaan (call to prayer) in the ear of the newborn. This is so that among the first sounds the baby hears are words declaring the Oneness of God. Another practice that is highly recommended (but not required) is to mash a dried date between one's fingers and let the baby have a taste or lick. This particular tradition hearkens back to the Prophet Muhammad who did this for his grandsons and other newborns brought to him after their birth. It is in acknowledgment of the newborn's need for nourishment and the fact that dates have the highest natural sugar content. Lastly, if the baby is a boy, arrangements need to be made for him to be circumcised.

Walker: In discussing childbirth education, what are the sources of childbirth education for Muslim women in your area of Toronto?

Hajara: The sources of childbirth education among Muslim women are the same as those for other women: prenatal classes, doctors & of course, friends. Typically, hospitals where women deliver often offer prenatal classes, but there are also a host of private childbirth educators as well.

Walker: Is it appropriate for a woman's husband to attend class with her?

Hajara: From an Islamic point of view there is nothing wrong with husbands attending childbirth education classes with their wives.

Walker: If a childbirth educator has a Muslim couple in class, what are specific things she needs to be mindful of?

Hajara: I can see two issues that childbirth educators may need to be mindful about if they have Muslim couples:

1. Muslim couples may not wish to watch videos or see pictures of actual births. This is because certain parts of the body (private parts) are considered an individual's private space and are not to be seen by others, be they of the same or opposite gender, the only exception to this being between spouses or for medical reasons.
2. Muslim couples may not wish to practice some of the breathing exercises, which may require the mom-to-be to assume actual birthing positions, in front of others.

Walker: Along those same lines, what accommodations should a childbirth educator make regarding information given: videos, handouts, exercises, etc.?

Hajara: Culturally competent ways of giving information may include letting couples know they don't have to watch the birthing videos if they are not comfortable with viewing it, so in other words, not making it a mandatory component of childbirth education classes.
With regard to the breathing exercises, childbirth educators can let couples know up front that private sessions are available (if they are) and/or let couples know that they are free to do the parts of the breathing exercise they feel comfortable doing and leave out the components they are not comfortable practicing in front of others. If this means a couple ends up practicing the deep breathing without being on their back, so be it!

Walker: Can you speak to the meaning of dress in Islam for women and how that would translate in child birth and after, and during breast feeding?

Hajara: Generally speaking, Islam has dress guidelines for both men and women, and they are in place for the purposes of maintaining one's modesty. For women, this includes covering everything except the face and hands in the presence of males that are not part of one's immediate family. That being said, this dress requirement is entirely waived when medically necessary, for example during childbirth, physicals, surgery, etc.
It's also important to note that the dress requirement for women in front of other women is significantly more lax and is why breastfeeding in front of other women is not an issue.

Walker: Would you think that a birth plan is an appropriate tool for a Muslim woman to use to state her needs and requirements?

Hajara: It's my understanding that birth plans are used to communicate one's needs, wishes and expectations for the labor and birth. If this is the case, birth plans may be the ideal tool to help communicate one's wishes, including one's faith based birth needs and requirements.

Walker: Are doulas commonly used?

Hajara: From an Islamic point of view, there is nothing that mandates or restricts the use of labour support, so that would be a decision left entirely up to the individual/couple. Though in my experience, a lot of Muslim women I know have traditionally tended to rely on labour support in the form of their own mom, sister or friend.

Walker: What are the general preferences between birthing in a hospital vs. home births?

Hajara: Again this is something that Islam doesn't really provide a guideline about, so I would say that the preferences among Muslim women would be the same as what one would see among women in general.

Walker: You were kind enough to review the Lamaze Six Practices for a healthy birth for this interview, what did you find?

Hajara: In terms of Lamaze's 6 practices of healthy birth, none of them appear to be in conflict with the Islamic approach to giving birth!

[Stay tuned for Part II of Walker Karraa's interview with Hajara Kutty...]

Hajara Kutty is an educator and postpartum mental health advocate. She is also the Greater Toronto Area Coordinator for Postpartum Support International (PSI) www.postpartum.net.com. Her articles on the topic of postpartum mental illness have appeared in media outlets across Canada. She lives in Toronto (Canada) with her husband, daughter and cat.

Posted by: Walker Karraa, MFA, MA, CD(DONA)

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