Maintaining wa (harmony): Japanese women negotiating their birth experiences in New Zealand

Keiko Doering
8 March 2013


Doering, K (2013). Maintaining wa (harmony): Japanese women negotiating their birth experiences in New Zealand (A thesis submitted in fulfilment of the degree Master of Midwifery at Otago Polytechnic, Dunedin, New Zealand) [PDF 2.626MB]


This thesis explores Japanese women’s birth experiences in Dunedin, New Zealand. New Zealand is a multicultural society comprised of people from diverse ethnic backgrounds. Currently, nearly 10% of the population identify as being of Asian descent, and this group has grown the fastest among all ethnic groups. A part of this demographic shift has been the rapidly increasing the Japanese population. In this social and cultural context, New Zealand health services have adopted the concept of cultural safety as an essential requirement for all health care providers. While the childbirth experiences of Māori, Pacific Islanders and Europeans have been well documented, this is not the case for Japanese and many other minority ethnic groups in New Zealand.

To begin to address this gap for Japanese women, a qualitative study was undertaken. Nine Japanese women currently living in Dunedin were interviewed. The key findings from the interviews were then further explored within a focus group comprising of four additional Japanese women. Thematic analysis was used to analyse the data and four main themes emerged as the results: 1) how the women understood the New Zealand maternity care system, 2) how they negotiated keeping Japanese customs, 3) the complexity of giving birth in another country, and 4) how the women dealt with cultural differences.

Building on some of the issues highlighted in the themes, the discussion chapter examines in greater detail how women understand and experience giving birth as a Japanese woman in the New Zealand context. The first discussion investigates how the different birth contexts between New Zealand and Japan and the Japanese women’s style of communication affect their birth experiences in New Zealand. The second area of concern focuses of the different perspectives on labour pain between the two countries, and how this difference shapes the birth experiences. Next, the study explores the importance of maintaining traditional birth practices in another country and support required to achieve this goal.

The discussion chapter concludes with a consideration of how these women negotiate their complex birth experiences in New Zealand through a Japanese philosophical worldview, such as maintaining wa (harmony), and investigates how the idea of maintaining harmony affects their care and experiences. Each discussion also highlights the strong influence of the care providers, especially midwives, on the women’s birth experience. It further recognises that understanding the cultural backgrounds of the women is required in order to improve their care.

The study concludes with several recommendations for midwives and health managers concerning cultural sensitivity, communication processes and practical support which would enable Japanese women to enjoy a safe and satisfying birth while also maintaining their own culture within New Zealand.

Keiko Doering's research was supervised by Jean Patterson and Christine Griffiths.



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