1. Section Editor(s): Angelini, Diane J. EdD, CNM, NEA-BC, FACNM, FAAN
  2. Perinatal Editor
  3. Bakewell-Sachs, Susan PhD, RN, PNP-BC
  4. Neonatal Editor

Article Content

The issue of Culture in Providing Perinatal and Neonatal Care is the topic for the first issue of The Journal of Perinatal & Neonatal Nursing's 27th year. We are happy to look broadly at the title of Culture both nationally and internationally. We would like to thank our many authors, national and international, who contributed to this particular issue.


In the perinatal section, there are 3 articles that concentrate on culture and the provision of care internationally. One article addresses cultural issues within the framework of an American population.


The first international article is "The Effect of Maternal Stress and Health-Related Quality of Life on Birth Outcomes Among Macao Chinese Pregnant Women." This study investigated the prevalence of preterm birth and low birth weight in Macao, and the effects of maternal perceived stress and health-related quality of life on these 2 birth outcomes. This is a quantitative study using a prospective longitudinal design undertaken in an antenatal clinic in Macao. The outcome data could help nurses design specific interventions for modifying risks in preterm birth and low-birth-weight infants in that population.


"The Prevalence and Predictors of Postpartum Depression Among Arabic Muslim Jordanian Women Serving in the Military" is the second international article. The purpose of this cross-sectional correlational study was to investigate the prevalence of symptoms and psychosocial predictors of postpartum depression among Arabic Muslim Jordanian women serving in the military. This study reviews the literature on postpartum depression in women serving in the military, in general. It also highlights interventions that would be useful for Jordanian military women but also applicable to women serving in the military in other countries.


"Promoting Cultural Humility During Labor and Birth in Northern Guatemala," using a low-tech, high-fidelity simulation-based provider-to-provider training in the management of obstetric and neonatal emergencies is the last international article. This training has been successfully tested and implemented in Mexico and will now be implemented in Guatemala. This article describes the process of curricular adaptation for that initiative.


"The Influence of Culture on Breast-feeding Decisions by African American and Caucasian Women" rounds out the last article in the Perinatal section. The purpose of this qualitative study was to examine how culture influenced breast-feeding decisions in African American and Caucasian women in the United States, using Leininger and McFarland's1 theory of Culture Care Diversity and Universality as a framework. The authors discovered that cultural influences might transcend race and include other aspects of a woman's cultural sphere.


The neonatal section of this first 2013 issue offers a spectrum of clinical and research articles relating to cultural aspects of and influences on perinatal and neonatal nursing. In addition, the columns provided by Drs Susan Blackburn, Jacqueline McGrath, and Terese Verklan offer relevant and useful information, analysis, and opinion.


The CE article by Premji and others is a review article on postpartum depression, preterm birth, and culture. Although postpartum depression is found across cultures, there are cultural aspects that can support or work against childbearing women in general and women experiencing postpartum depression in particular. The article has a specific emphasis on Pakistani culture; however, a broader consideration of cultural impact on women and childbearing women is also provided.


Sacks et al describe a qualitative study on traditional birth attendants in Honduras. Traditional birth attendants provide the majority of services to healthy newborns until the 2-month vaccine visit at the health clinic. Laywomen such as these birth attendants are important health support workers in many cultures, although still relatively rare in the United States. The potential for them to have additional knowledge and impact is an issue raised by the authors.


Fathers play important and varied family and parental roles. Compared with research on mothers, much less has been described about fathers in the neonatal intensive care unit. Feeley and her coauthors present interviews with fathers who have infants in the neonatal intensive care unit. Although not focused on cultural differences, the literature review includes culture as a context that influences fathers' roles. The study findings include 3 patterns of paternal involvement.


African American women in the United States are at greater risk for preterm birth than white women. Preterm birth has multiple contributing factors, including stress. Giurgescu and her colleagues studied the stressors, resources, and stress responses in pregnant African American women. They describe patterns of stress responses both in a group of women and in some of their significant others. Implications of this work relates to the importance of periodic assessment of stress among pregnant African American women.


-Diane J. Angelini, EdD, CNM, NEA-BC, FACNM, FAAN


Perinatal Editor


-Susan Bakewell-Sachs, PhD, RN, PNP-BC


Neonatal Editor




1. Leininger MM, McFarland MR. Culture Care Diversity and Universality: A Worldwide Nursing Theory. 2nd ed. Sudbury, MA: Jones and Bartlett;2006. [Context Link]