# Family Coaching for Pregnant Women in Developing Countries: Cultural Sensitivity and Supporting Well-being

> Family coaching insights from exchange program in Maputo.

## Introduction
Prenatal family coaching plays an important role in the well-being of mothers and families, but implementing it in developing countries presents specific challenges. This article discusses the experiences and lessons learned while conducting family coaching for pregnant women and their families within the framework of an exchange program in Maputo, Mozambique. We focus on home visits and the impact of cultural differences and the various life situations of families on midwifery work.

## The Future Health Hub (FHH) Project
This family coaching was part of the Future Health Hub (FHH) project, funded by Team Finland Knowledge, which aims to promote cultural understanding, Evidence-Based Practice (EBP), and collaborative problem-solving among students. The FHH project seeks to create a model that enables multicultural work and supports the professional development of health students.

The project brings together students from the Savonia University of Applied Sciences and the Instituto Superior de Ciências de Saúde (ISCISA). The collaboration provides an opportunity for students to develop professional skills and cultural understanding in a healthcare context. As part of this initiative, students aimed to help pregnant women and their families create a safer environment that promotes maternal well-being and prepares the family for the arrival of the baby.

## Coaching Focus and Home Visits
The coaching focused on the well-being of women and families, nutrition, psychological support, and practical preparations for the arrival of the baby. 

During our first home visit, we encountered the realities of life in a densely populated neighborhood without access to running water. The family lived in a single room with five people: the pregnant woman, her two children, and her parents. Cooking was done over an open fire in an outdoor shelter, and water was collected from a communal point. Despite the modest living conditions, the family was warm and hospitable, highlighting the importance of family support and community during pregnancy.

## Cultural Sensitivity in Midwifery
The physical health of a pregnant woman is only one aspect of well-being; family relationships and cultural factors significantly affect the support women receive. Cultural differences were evident in how families perceived outsiders. For many, it was difficult to trust students from a different community, fearing that outsiders might not understand their needs or culture. In this environment, cultural sensitivity and the ability to communicate openly and respectfully became crucial.

Family coaching provided an opportunity to discuss daily practices such as nutrition, hygiene, and family relationships, alongside emotional support. Home visits facilitated these discussions in a trusting environment.

## Lessons Learned
This experience taught us that midwifery in developing countries requires a significant amount of cultural sensitivity and the ability to adapt to different living conditions, compared to the more technical and clinical focus often found in Finland. We learned to:
* Consider the whole family situation, including financial and social circumstances.
* Realize that our own approaches may not always resonate with local families.
* Listen more, be empathetic, and adapt to different life situations.

The experience strengthened our understanding that the role of a midwife involves providing emotional and cultural support to help families navigate the challenges of pregnancy.

## Authors
* **Susanna Honkala**, Midwife-student, Savonia – University of Applied Sciences, susanna.honkala@edu.savonia.fi
* **Maria Polvinen**, Midwife-student, Savonia – University of Applied Sciences, maria.polvinen@edu.savonia.fi
* **Nanna Eklind**, Midwife-student, Savonia – University of Applied Sciences, nanna.eklind@edu.savonia.fi
* **Oona Kähkönen**, Senior lecturer, Savonia – University of Applied Sciences, oona.kahkonen@savonia.fi
* **Marja Gröhn-Rissanen**, Senior lecturer, Savonia – University of Applied Sciences, marja.grohn-rissanen@savonia.fi