Journal de la grossesse et de la santé infantile

Abstrait

We all decided: The variations of Hmong Family-Based Decision-Making about Maternity Care in Thailand

Kathleen A Culhane-Pera, Sarinya Sriphetcharawut, Rasamee Thawsirichuchai, Wirachon Yangyuenkun and Peter Kunstadter

Objective: A recent survey in Northern Thailand found that pregnant Hmong women use maternity services less than Thailand’s national statistics. Our objective was to identify which Hmong family members participated in maternity care decisions in order to include appropriate family members in interventions that might increase use of maternity services.
Design: We conducted in-depth qualitative case-studies of 16 families in one Hmong village in Northern Thailand. We chose 16 women with and without maternity services, and interviewed them, 12 husbands, and 17 elders about decisions for all pregnancies.
Results: There is a continuum of family-based decision-making, which ranges from elders alone, to elders with couples, to couples by themselves, to women alone without their husbands or husbands’ family. This continuum illustrates that no one family-based decision-making pattern exists, different family members participate at different times, particularly over the life-cycle, and pregnant women are embedded in dynamic social processes where women may have little or no influence, considerable influence, or act independently of husbands and husbands’ families. No one pattern chose maternity services more than another; some elders and husbands were as supportive of modern maternity services as were pregnant women; and some pregnant women were against maternity services, regardless of husbands and elders’ opinions. Women’s ideal is to be supported by their husbands and husbands’ family members.
Conclusion: Educational programs designed to increase use of maternity services should recognize the diversity of decision-making patterns found to exist in Hmong families and offer involvement to all family decision-makers, including women, their husbands, or family elders.