Strive for cultural competency to improve perinatal care.(methods)

STANFORD, CALIF. -- The young woman who arrived in labor was accompanied by a large and loud crowd of extended family members who spoke little English. With each contraction, the family yelled louder, Marylouise Martin, recalled.

Instead of simply asking them to be quiet or leave, she pulled aside one of the family members and asked why they were all yelling. "Must yell," the man told her. "Louder you yell, more beautiful baby will be."

Cultural differences made the yelling irritating to staff members but a routine part of the birth process to the family, she said at a conference on perinatal and pediatric nutrition.

After a separate, nearby room was found for the family to carry on in, everyone was satisfied, said Ms. Martin, a nurse educator at McLeod Regional Medical Center, Florence, S.C.

She told another tale of a male resident physician at an unnamed hospital who was called to substitute at the last minute for a female physician who could not arrive in time to deliver her patient's baby. The mother cried and tried to refuse his care. The woman's husband fought to remove the resident from the room and was taken away by hospital security officers. The baby was delivered, but the parents left the hospital shortly after the birth without the baby. In their eyes, the woman had been violated, and they could not keep the baby.

The stories illustrate why it's important to pursue cultural competence--the accrual of knowledge and skills that enable providers to adapt health ...