Many developing countries implement safe motherhood programs to tackle high maternal mortality rates. The approach requires recognition of the signs of emergency obstetric cases in order to facilitate immediate care seeking, followed by immediate medical care. Whether such signs are recognized in a timely manner at the community level is determined by how the community perceives health problems. We explore the local understanding of one danger sign—bleeding during pregnancy and at delivery—and the meaning attached to it. The study was conducted in the Kavrepalanchowk district of Nepal. Different qualitative methods were applied. The findings indicate that the community's perception of bleeding might be quite different from that of health professionals and that perceptions and meanings attached to bleeding vary depending on the actors in the family. They all have significant implications for what should be the focus of health education and who should be involved in promoting maternal health.
Afsana, K., & Rashid, S.F. (2000). Discoursing birthing care: Experiences from Bangladesh . Dhaka: University Press Limited .
2.
Al-Nahi, Q., & Post, M. (1998). Health seeking behavior of women in five safe motherhood districts in Nepal. Kathmandu: UNICEF.
3.
Bennett, L. (1976). Sex and motherhood among the Brahmins and Chhetris of east-central Nepal. Journal of the Institute of Nepal and Asian Studies: Contributions to Nepalese Studies-Anthropology, Health and Development, 3, 1-52.
4.
Bennett, L. (1983). Dangerous wives and sacred sisters: Social and symbolic roles of high-caste women in Nepal. New York: Columbia University Press.
5.
Blanchet, T. (1984). Women, pollution and marginality: Meanings and rituals of birth in rural Bangladesh. Dhaka: University Press Limited.
6.
Blanchet, T., & Zaman, A. (1999). Women's reproductive health: Problems and issues in greater Sylhet. Anthropological input to inform CARE-NIRAHPAD MA Project at its onset. Dhaka: CARE/Bangladesh .
7.
Campero, L., Herrera, C., Kendall, T., & Caballero, M. (2007). Bridging the gap between antiretroviral access and adherence in Mexico. Qualitative Health Research, 17(5), 599-611.
8.
Chawla, J. (1994). Child-bearing and culture. Women-centered revisioning of the traditional midwife: The dai as a ritual practitioner. New Delhi: Indian Social Institute.
9.
Foster, G.M. (1976). Disease etiologies in non-western medical systems . American Anthropologist, 78(4), 773-782.
10.
Gummi, F.B., Hassan, M., Shehu, D., & Audu, L. (1997). Community education to encourage use of emergency obstetric services, Kebbi State, Nigeria. The Sokoto PMM Team. International Journal ofGynaecology and Obstetrics, 59(Suppl. 2), S191-200.
11.
Hill, K., AbouZhar, C., & Wardlaw, T. (2001). Estimates of maternal mortality for 1995. Bulletin World Health Organization, 79(3), 182-193.
12.
Jeffery, P.M., Jeffery, R., & Lyon, A. (1985). Contaminating states and women's status. New Delhi: Indian Social Institute.
13.
Jeffery, P.M., Jeffery, R., & Lyon, A. (1989). Labour pains and labour power: Women and childbearing in India. London: Zed Press.
14.
Kadir, M.M., Fikree, F.F., Khan, A., & Sajan, F. (2003). Do mothers-in-law matter? Family dynamics and fertility decision-making in urban squatter settlements of Karachi, Pakistan . Journal of Biosocial Sciences, 35(4), 545-558.
15.
Kwast, B.E. (1995). Building a community-based maternity program. International Journal of Gynecology and Obstetrics, 48(Suppl.), 567-582.
16.
McGilvray, D.B. (1994). Sexual power and fertility in Sri Lanka: Batticaloa moors and Tamils. In C. P. MacCormack (Ed.), Ethnography of fertility and birth (2nd ed., pp. 15-63). Prospect Heights, IL: Waveland Press.
17.
Ministry of Health, His Majesty's Government of Nepal and UNICEF, Nepal. (1996). Children and women in Nepal: A situation analysis. Kathmandu: UNICEF.
18.
Ministry of Health, Nepal. (2001a). Annual report, Department of Health Services 2056/57 (1999/2000). Kathmandu: Department of Health Services/MOH, Family Health Division.
19.
Ministry of Health, Nepal. (2001b). Nepal demographic and health survey. Kathmandu: Department of Health Services/MOH, Family Health Division.
20.
Nwakoby, B., Akpala, C., Nwagbo, D., Onah, B., Okeke, V., Chukudebelu, W., et al. (1997). Community contact persons promote utilization of obstetric services, Anambra State, Nigeria. The Enugu PMM Team. International Journal of Gynecology and Obstetrics, 59(Suppl. 2), S219-224.
21.
Portela, A., & Santarelli, C. (2003). Empowerment of women, men, families and communities: True partners for improving maternal and newborn health. British MedicalBulletin, 67(1), 59-92.
22.
Rashid, S.F. (2001). Indigenous notions of the workings of the body: Conflicts and dilemmas with Norplant use in rural Bangladesh. Qualitative Health Research, 11(1), 85-102.
23.
Subedi, P. (1993). Nepali women rising. Kathmandu : Sahayogi Press.
24.
Thompson, C. (1985). The power to pollute and the power to preserve: Perceptions of female power in a Hindu village. Social Science and Medicine, 21(6), 701-711.
25.
UNICEF Nepal (2006). Situation of children and women in Nepal. Kathmandu: UNICEF.
26.
Watkins, R.E., & Plant, A.J. (2004). Pathways to treatment for tuberculosis in Bali: Patient perspectives. Qualitative Health Research, 14(5), 691-703.
27.
Weller, S.C., & Romney, A.K. (1988). Systematic data collection. Thousand Oaks, CA: Sage.
28.
World Health Organization. (1990). Maternal health and safe motherhood program. Progress report, 1987. Geneva, Switzerland: Author.
29.
World Health Organization. (1991). Safe motherhood newsletter, No. 6. Geneva, Switzerland: Author.
