Prolonged sexual abstinence after childbirth: gendered norms and perceived family health risks. Focus group discussions in a Tanzanian suburb

Abstract

BackgroundProlonged sexual abstinence after childbirth is a socio-cultural practice with health implications, and is described in several African countries, including Tanzania. This study explored discourses on prolonged postpartum sexual abstinence in relation to family health after childbirth in low-income suburbs of Dar es Salaam, Tanzania.MethodsData for the discourse analysis were collected through focus group discussions with first-time mothers and fathers and their support people in Ilala, Dar es Salaam, Tanzania.ResultsIn this setting, prolonged sexual abstinence intended at promoting child health was the dominant discourse in the period after childbirth. Sexual relations after childbirth involved the control of sexuality for ensuring family health and avoiding the social implications of non-adherence to sexual abstinence norms. Both abstinence and control were emphasised more with regard to women than to men. Although the traditional discourse on prolonged sexual abstinence for protecting child health was reproduced in Ilala, some modern aspects such as the use of condoms and other contraceptives prevailed in the discussion.ConclusionDiscourses on sexuality after childbirth are instrumental in reproducing gender-power inequalities, with women being subjected to more restrictions and control than men are. Thus, interventions that create openness in discussing sexual relations and health-related matters after childbirth and mitigate gendered norms suppressing women and perpetuating harmful behaviours are needed. The involvement of males in the interventions would benefit men, women, and children through improving the gender relations that promote family health.

Perceptions about the cultural practices of male partners during postpartum care in rural Tanzania: a qualitative study

“…Men were in charge of providing for the family and they were expected to fulfill this role during the postpartum period, as well as at other times. Our findings are similar to those of other studies, which show that men are the main breadwinners and women depend on them for economic support [38,48,56,57]. This study also points out that men were not the most involved in ‘caring’ and household work while the postpartum mother was convalescing.…”

“…Previous studies in many countries, including Tanzania, show similar results, namely women depending on their male partners to make decisions on whether and where to seek medical care, which limits women’s right to sexual and reproductive health [17,18,38,41,43,44]. However, this prevalent position is not universal [34].…”

“…Health professionals do not expect them to come, do not encourage them and may have negative perceptions of men’s involvement [13,25]. Numerous studies have also indicated the barriers that men face in accessing health services for themselves and becoming engaged with services during pregnancy and childbirth [1,26,34,38]. Policies and programs should take into consideration these societal barriers if they want to enhance men’s engagement during this period.…”

“…Existing research has been conducted in urban areas and focused mainly on breastfeeding and prevention of mother-to-child HIV transmission [35–38]. The situation in rural areas, where the implementation of guidelines may be more erratic and the influence of social norms hindering men’s involvement may be stronger, has not been explored.…”

Saving lives with caring assessments: How Tanzanian nurse‐midwives and obstetricians negotiate postpartum practices

“…Others continued to build upon Lugina's research. For example, the inclusion of men during pregnancy, labour and the postpartum period continues to be an important consideration today and is proposed as necessary for the improvement of maternal/child health outcomes (Mbekenga, Pembe, Darj, Christensson, & Olsson, 2013;Mbekenga et al, 2009). Support for new mothers during the postpartum period is often provided by informal caregivers such as traditional birth attendants, family, community members and neighbours (Mbekenga, Christensson, Lugina, & Olsson, 2011;Mbekenga et al, 2009).…”