Mother-Daughter Relationship: Overcoming Shyness about Discussing Reproductive Health
Fatima is a ten year old girl living with her family in a small village of Pakistan. She is a school going child. One day upon returning from school, she could feel her private parts getting wet and started having severe abdominal pain as if someone had placed a heavy stone over her abdomen. On inspection, she observed that she was bleeding.
She got confused and did not tell her mother about it as her cultural circumstances did not allow her to talk to her mother openly about it. She remained isolated in her room for a few days. She then observed that her bleeding had stopped but her abdominal pain was still there. Her mother then inquired about her condition and Fatima briefly described the situation she was suffering from, since the last few days.
Her mother took her to the nearest Health Care Centre where it was identified as a vaginal infection due to improper care during her menstruation. She was then treated with multiple antibiotics and got discharged from the hospital.
Changes in life are inevitable and they are present at every step of life. No one can defy the changes they are being exposed to. These changes can be categorized as physical, emotional and psychological. Teenage girls face this change in the form of puberty and hence feel shy to talk to their family about it. Moreover, most of the girls are aware of the upcoming change through media but they still find it tough to share it with their mothers even.
Although this communication gap is more common in rural areas as compared to urban areas because of the low level of education and awareness, no statistics have been reported yet. Ackard et al (2006) investigated the parent-child relationship, behavioral and emotional health amongst 4746 adolescent students. They found that adolescents who received little or no care from their mothers, reported high prevalence rates of unhealthy weight control behaviors (63.49% girls, 25.45% boys); suicide attempts (33.51% girls, 21.28% boys); low self-esteem (47.15% girls, 24.56% boys); and depression (63.52% girls, 33.35% boys).
Most of the time, pubertal changes and the revolving taboo around them in our society renders a girl shy and awkward , when it comes to discussing such issues with others and hence end up feeling stigmatized. Another aspect is that, it is considered inappropriate in our culture to talk regarding puberty. It is mainly because of the shyness, a basic personality trait in women. In addition to this, there is a prohibitory line for discussion on sexual education, be it privately or publicly. These thoughts needs to be modified in order to minimize the mortality and morbidity rates linked with this issue.
As a transcultural nurse (TCN), the basic role is to create awareness amongst women, both mother and daughter, to talk about this to each other openly and without any hesitation. We need to teach mothers to accept and respect their daughters’ shyness. When a mother has adequate information about the natural changes of puberty with her daughter and she knows and uses communicational skill in this conversation, an adolescent girl may feel more comfortable to ask her questions about this subject. Therefore pre-adolescent girls perceive these changes as natural signs of maturity instead of developing a fear and negative attitude towards puberty. Mass education could also be one of the strategies to improve timely healthcare seeking and utilization through behavior change and life style modifications.
Mothers are not adequately trained to deal with their daughters. The school must also conduct sessions, in collaboration with different health care institutes, to make girls more aware and to educate them about the pubertal changes. Psychological, emotional and behavioral changes are a part of personality traits in an adolescent girl as it is associated with pubertal changes. Mother-daughter communication can become a strengthening factor to overcome the gap. In addition, maternal teaching and sessions at schools for girls may help both, mother and daughter, to get to know more about it, prior to experiencing it in a sudden way.
About the Author: Kiran Bardai is a nursing student at Aga Khan University School of Nursing, Pakistan. She can be reached at firstname.lastname@example.org
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