Cultural practice is the manifestation of a culture or sub-culture, especially in regard to the cultural practices and customary practices of a particular ethnic or other cultural group. It affects perceptions of health and illness and beliefs about causes and treatment of disease, approaches to health, how illness and pain are expressed, where, when, and how pregnant women seek help, and the type of treatment pregnant women prefer and adhere to.

Cultural impact changes that affect individual surroundings Tourists have a cultural impact as a result of their influx. During pregnancy, women from Akpabuyo Local Government Area do not eat certain foods; during pregnancy, women do not move too much and prefer lying down; during pregnancy, women from Akpabuyo Local Government Area prefer sitting or squatting. The father does not attain the birth, but the mother or the mother-in-law does.

Cultural practices that are practice in Akpabuyo Local Government Area Abdominal massage, prohibition of food, taking different types of herbs, and doing extraneous exercise were the major cultural practices reported by study participants. One of the most prevalent ways in which pregnant women's rights are actually violated is through cultural practises, which are forms of violence that are accepted in Akpabuyo Local Government Area. The government should eradicate cultural practices by conducting research into the root causes, implementing transformational change programmes, and consulting on local and national legislation regarding cultural practices.

The main factor that prevents women from receiving care during pregnancy is cultural practices. The aim of this study was to assess the level of cultural practices and their impact on the health of pregnant women. In this study, we found that low maternal education in rural areas, lack of antenatal care, and lack of trained birth attendants in primary health care clinics in Akpabuyo Local Government Area were the risk factors associated with pregnant women employing cultural practices during the perinatal period. Thus, strong multi-sectorial and oral collaboration targeting improving pregnant women’s educational status and primary health care workers should take up the active role of pregnant women’s health education. Apart from primary health care workers, the government should also create awareness among pregnant women. The government should come up with policies that help promote pregnant women’s formal education. Maternal and neonatal mortality remain serious problems in low-resource settings where healthcare systems do not meet the minimum standards set by the World Health Organisation (WHO), despite growing recognition of the critical importance of providing care to pregnant women. Early pregnancy was a common cultural practice as shown in the quote.

Anytime I got pregnant, it does not stay, so I was told

It is because when you are pregnant, and you go out

People will see you go out

People will look at you with evil eyes to spoil your pregnancy.

So I stay at home so I can have a successful birth

This is the cultural practice pregnant women adhere to. The respondents prefer home delivery; as for the effect of home deliveries, 8% of the respondents reported that their relatives died of maternal problems, of which home delivery was responsible for 11% of deaths, while health facilities were responsible for 3%.

Culture and practice can also determine gender norms that deny women the ability to make their own decision to seek care. Globally, more than half a million pregnant women die in childbirth due to cultural practices. Cultural sigma in the communities, for example, husbands who insist on their wives doing difficult house chores when they are pregnant-can have a serious impact on maternal mortality.

In Akpabuyo Local Government Area, the people perform rituals and consult with traditional doctors for medication in the belief that they will be healed. This will even worsen the situation because the traditional doctor will give you all types of herbs that they will use to end up losing their babies. These practices are deeply rooted and embedded in these societies, and therefore they become part of the people's lives. It was noted that community members were innate to such an extent that they tried to change it, but it was difficult to change their beliefs and practices, as they adhered to them throughout their entire lives. Individuals adhered to their grandparent’s knowledge in the belief that they knew better since there were others before them.

In Akpabuyo, it is believed that when it is masquerade season, all pregnant women should not go out and should stay indoors. This can cause them joint pain, which can lead to maternal mortality.

Counselling this group of persons will also reduce the crime rate and assist professional counselling programmes in the creation of curricula and educational experiences that can address the health of pregnant women, cultural beliefs, and the effective practice of primary health care [1]. Education shapes humans. Being positive, education is a human right that should be bestowed on human beings exclusively by reason of being human [2].

In Akpabuyo Local Government Area, cultural practices avert women from accessing antenatal delivery and postnatal care, have a significant influence on the place of delivery, and increase the probability of home delivery. In Akpabuyo Local Government Area, the range of restrictive cultural practices through pregnancy and the postpartum period was revealed, and a wide range of good and bad foods continued to have currency through the perinatal continuum with little consensus between groups of what was beneficial versus what was harmful. In Akpabuyo Local Government Area, there are varieties of nutritious food items that are avoided during pregnancy and the post-natal period, increasing the vulnerability of pregnant women to malnutrition. It was also shown that a wide variety of cultural practice were identified during various stages of the perinatal period. Most of the participants expressed that their families believed that pregnant women should not eat green vegetables, yams, or mangoes and that they should eat less during pregnancy.

The government should have potential relevance and significance in understanding the magnitude of the problem, making evidence-based decisions, and taking appropriate action by developing a health care plan, policy, and programme to resolve the cultural practices in Akpabuyo Local Government. Culture is a historic phenomenon whose development is determined by the succession of cultural practice formations. Culture as a whole is a product of the activities of the masses; it is characterised by relative independence and continuity of development, is subject to the impact of the culture of other people, and accordingly assumes a class character. In any class society as to its ideological contents, aims, and objectives. It implies all material and spiritual values-the total value of all that has been produced from one generation to another.

1. What Are The Health Beliefs Of a Pregnant Woman?
2. What Are The Cultural Practice In The Community In Akpabuyo L.G.A.?
3. What Are The Cultural Practice That Seek Delay In Seeking Health?
4. What Is The Cultural Impact On Pregnant Women In Akpabuyo Local Government Area?

The impact of cultural practice on pregnant women

For example, during pregnancy, women from some cultures avoid moving too much; some prefer to sit and squat. In some cultures, the father does not attend the birth, but the mother or mother-in-law does. After childbirth, some women follow strict rules, such as staying in bed for several days. Different cultures have different values, beliefs, and practises. A woman's culture and background can affect her needs and expectations during pregnancy.

The harmful cultural practice and its effect on pregnant women

The commonly mentioned harmful cultural practice in Akpabuyo Local Government Area include food restrictions and taboos such as abdominal and uterine massage during home delivery, avoiding colostrum, clotting the umbilical cord with usterile sharp materials, delaying the initiation of breast feeding, giving water or butter to new-borns, etc. The above cultural practices can affect a pregnant woman physically, psychologically, and also during her perinatal period. Besides, other researchers have identified diverse sociocultural factors such as family structure, peer group influence, cultural permissiveness, family instability, early age of marriage, lack of knowledge, and ineffective use of contraceptives to influence pregnancy. It is the ability of the individual to adapt to a new way of living by adjusting to the psychological and social conditions that appear to him or her (Effiom, Bassey Ekeng, Maria E.N., Lucy O.A., and Ugbe, B.U. 2022). In many settings, women face limited mobility to reach health facilities, restricted decision-making power in their health seeking, as well as limited access to and control over resources needed for advancing their health, like information about antenatal care (Effiom, Bassey Ekeng, Janet Petters, Mercy Lawrence Ekwok, Unima, Felix Unima, and Favour Idowu Ojedor, 2023).

The Role of Culture and Practice in Influencing Sexual and Reproductive Health

Sexual and reproductive health (SRH) is vital for general health; however, problems of SRH, such as unwanted pregnancy, sexually transmitted infections (STIs), and complications during pregnancy and childbirth among adolescents, frequently arise due to risky sexual behaviour, often linked to cultural practices.

Summary of the Literature Review

Depending on your social, religious, and cultural background, you may have certain needs and expectations when having a baby. In Akpabuyo Local Government Area, each woman has a choice about where and how she has her baby. Different cultures have different values, norms, beliefs, and practices. Cultural practices in Akpabuyo Local Government Area can affect a pregnant woman's needs and expectations and also increase the maternal mortality rate in Akpabuyo Local Government Area.

In summary, the government should open more schools, and it should also provide medical facilities for primary health care workers. And also, the government should produce a counselling centre in Akapabuyo Local Government Area to help reduce the maternal mortality rate in Akpabuyo Local Government Area.

The research design used for the study was a descriptive research design. The descriptive design was used in the analysis of the characteristics and phenomena of the study area. This design is considered appropriate because it gives the researcher the opportunity to study a large population through the use of randomization, which allows for generalisation of results based on the sample. The design allows the researcher to use the population for the study by studying the sample and drawing references about the character of the required population from the sample, which will be generalised to the whole population. Sustaining the whole population is time-consuming.

The target population of pregnant women in Akpabuyo LGA The population of the study comprises 50 primary health care workers and 200 pregnant women; thus, the total population of the study is two hundred and fifty (250).

The sample refers to a representative portion of the population selected for the study. The sample size used for the study was 200 respondents, and the sampling technique employed was a complete enumeration method. The sample determines the generalization of the results of the study for the population. Based on the above, the stratified random sampling technique was used for the purpose of achieving the study objective in the primary health care clinic in Akpabuyo Local Government Area.

The instrumentation used for the study was a questionnaire. The Questionnaire was structured in two sections: section A was designed to collect demographic information from respondents, while section B was structured to provide an answer to the research question. Questions contained in this questionnaire were simple enough for the respondent to provide an answer to. Instrument use for the study uses space and content validated by the project supervisor, and the questionnaire was rectified as appropriate before it was administered to the respondent. The reliability of the questionnaire was checked using the test-and-retest method. Information used for this study was elicited using the questionnaire. A questionnaire was administered by the researcher. To ensure a 100% response rate, the questionnaire was completed in the presence of the researcher. Information elicited proved to be useful for the analysis and relevant conclusion of the work. The researcher made a visit to a primary health care centre to be used for the study and sought the permission and assistance of the head of the primary health care centre and staff. It was agreed and scheduled on a date that is convenient for all stakeholders concerns.

Table 1: The data were presented in tables and analyzed using simple percentage.

The table show that in the gender of the respondent male 60 respondent representing 30% while female 150 of the respondent representing 70% were female this means that the female are more than the male.

Table 2: Age Distribution of the Respondent.

The table 4.2 above show the age distribution of the respondent, it shown that 10(20%) were between 20-25 were between 25-30 of age 36(10) were between 31-35 of age 40(5%) were between 36-40 of age were between 21(16%) were between 40-45 of age 62(21%) were between 46-50 of age 22(19%) 51 above of age were 19 (19%).

Table 3: Distribution of the Respondent According to their Marital Status.

The table 4.3 above shows the distribution of the respondent according to their marital status it shows that 60 (40%) were single with 150(60%) were married this shows that married people were more than single in the study.

Table 4: Distribution of the Respondent According to their Profession.

In research question 1, what are the effects of cultural practice on the health of pregnant women? During pregnancy, women do not move too much; this was supported by 150 (65%). During pregnancy, women do not eat certain foods, as supported by 170 (65). During pregnancy, women follow strict rules, such as staying in bed for seven days, as supported by 120 (76). In some cultures, the father does not attend the birth, but the mother or the mother-in-law does 180 (85).

In research question 2, what are the possible ways to tackle cultural practice? Be open-minded; 160 (76%) efficient communication awareness was supported by 180 (90). Establish clear rules, but don’t rely on them, was supported by 170 (85). The use of simpler and more accurate language was supported by 200 (60).

In research question 3, what are the cultural practice that are practiced in Akpabuyo Local Government Area? Included food restriction, abdominal massage, and home delivery were supported by 140 (75%), avoiding colostrum, cutting the umbilical cord with sharp materials was supported by 180 (60%), delaying the initiation of food was supported by 130 (55%), and giving butter or water to the new-born was supported by 154 (45%).

In research question 4, what are the cultural practices that affect health in Akpabuyo Local Government Area? These include: Early child marriage was supported by 185 (54%). Female genital mutilation was supported by 146 (58%); corporal punishment was supported by 199 (60%); and scarification was supported by 120 (59%).

In research question 5, what are the cultural factors that contribute to the maternal mortality rate in Akpabuyo local government area? Illiteracy was supported by 135 (71%). Poverty was supported by 129 (56%); ignorance was supported by 156 (51%). Poor use of available maternal services was supported by 140 (75%).

This study presents cultural practise and their impact on pregnant women. Culture can be defined as the identity of a person. Culture differs from one area to another, and the culture basically presents the way the people think and act. There are many people who do not believe in culture, but there are still many who believe in their cultural practices.

The cultural practices also include beliefs regarding health care in Akpabuyo Local Government Area, which has different cultures about health care. Cultural practices can affect human health, including that of pregnant women. In conclusion, harmful cultural practices were found to be high in the study area. The government should take on the role of educating women about the cultural practice and its impact on pregnant women.

Recommendation

In order to decrease cultural practice the following should be considered;

1. The government should provide a committee and send them to Akpabuyo local government area to educate them on cultural practices and their impact on the health of pregnant women.
2. The government should educate primary health care workers.
3. The government should enlighten pregnant women about cultural practices. There is a need for pregnant women to be aware of the effects of cultural practices.
4. The state government should also educate pregnant women and stop cultural practices that will harm a pregnant woman.
5. The federal government should also establish more schools.
6. Pregnant women should be encouraged to assist the government in eradicating cultural practices.
7. There should be a government organization that will help fight cultural practices in the Akpubuyo Local Government Area.
8. Cultural practices should be included in the curriculum to help provide education to pregnant women.

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