Exploring Indigenous Ways of Childbirth Management and its Perinatal Outcomes During Cyclonic Periods in Hilly Tribal Homebirth Settings: A Qualitative Observational Study

Abstract

Objective

This study explores the cultural-based management of childbirth vulnerabilities in the hilly regions during cyclone periods, where the land mass has been frequently exposed to floods during and aftermath of cyclones due to low-high cyclonic depressions in the Bay of Bengal coast.

Methods

The present study was a community-based qualitative observational study conducted for three weeks immediately after the two cyclonic periods occurred between October and December 2022. With the purposive sampling method, 21 postpartum mothers were selected on the inclusion criteria, of having had childbirth around the cyclonic period of ‘Sitrang’ (late October 2022) and ‘Mandous’ (early December 2022). Semi-structured in-depth interview schedules were employed to document socio-demographic profiles and probed for their cultural ways of managing childbirth complications and neonatal exposures to infections during the cyclonic period.

Results

Views of 21 mothers were coded into three themes with two sub-themes each according to repeated frequencies of information. The themes were (a) Striving for Safe Childbirths; (b) Surviving with Traditional Capacities; (c) Strength and Sustenance. The results indicated that home deliveries were considered safest over institutional deliveries except in the cases of complicated childbirths confirmed difficult by the traditional birth attendants (TBA). Rough climatic conditions compounded by geographical distance, lack of appropriate financial help and timely transportation facilities were the major prevailing factors influencing their childbirth practices during the cyclonic periods.

Conclusion

Disasters do not alone influence childbirth outcomes, but the evidence is still mixed. The expediency of birth technology has effectively managed childbirth vulnerabilities. Ensured sleep, rest and enough food had also been disturbed during and aftermath cyclones. The results showed an urgent need for focused planning on tribal areas for gestation, birthing and postpartum people during natural disasters.