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lOMoAR cPSD| 42619430
Negotiating WA (Harmony): A Qualitative
Study About the Challenges Japanese
Women Who Live in New Zealand Have
in Maintaining Their Birth Traditions
Keiko Doering, Jean Patterson, and Christine Griffiths
Cultural birth customs play an important role in maintaining women’s psychological well-being
throughout childbearing. The goals of this study were (a) to explore how Japanese women living in
New Zealand keep or perform their birth traditions, (b) to educate caregivers about the importance of
these traditions to Japanese women, and (c) to provide an environment within which Japanese women
feel able to express and negotiate their cultural practices.
Following ethical approval from the Otago Polytechnic Research Ethics Committee (ETHICS 470),
13 Japanese women, who had given birth in New Zealand within the previous 3 years, were
interviewed individually, or in a focus group. Transcripts of the interviews were analyzed using
thematic analysis. The women were all born in Japan, had moved to New Zealand in their 20s, and
lived in New Zealand for a period between 2 and 19 years.
The women valued their birth traditions and tried to practice these throughout their pregnancy and
following birth. This was not always possible within the New Zealand maternity and cultural setting
where there was a lack of support or understanding from family and care providers. There was also lim-
ited access to shrines where they could perform the rituals. This caused some of the women to experi- ence cultural conflicts.
The desire to maintain harmony with others and the environment is embedded in Japanese culture, and this
made it difficult for the women in this study to express their need to fulfill these practices and rituals.
Although this study focused on Japanese women’s attitudes and cultural practices, it highlights the
importance of being able to maintain a woman’s cultural links, particularly around childbirth. It is
essential for caregivers to understand that each woman brings her own cultural understandings and
traditions to her birth experience and that the support to practice birth rituals contributes to her peace of mind and well-being.
KEYWORDS: childbirth; birth customs; umbilical cords; cultural differences; Japanese women; New Zealand INTRODUCTION
(DeSouza, 2005; Naser et al., 2012; Yoshida, 2008).
Maintaining cultural practices are often important for
The birth customs and rituals of a culture have an
women giving birth in a country other than the one in
important role in maintaining the psychological well-
which they were raised. Practicing cultural traditions
being of childbearing women and may help women
helps to connect childbearing women with their fam-
cope with and reduce the anxiety and fear of childbirth
ily, which is particularly important when giving birth.
INTERNATIONAL JOURNAL OF CHILDBIRTH VOLUME 6, ISSUE 1, 2016
© 2016 Springer Publishing Company, LLC www.springerpub.com
http://dx.doi.org/10.1891/2156-5287.6.1.27 27 lOMoAR cPSD| 42619430
28 Negotiating Wa (Harmony) Doering et al.
For Japanese women, the traditional rituals around birth
As recommended by Sandelowski (2000, 2010), two
offer something to believe in and a peaceful state of mind
methods of data collection, individual and group inter-
(Taniguchi, Matsuyama, & Shimada, 2000). However,
views, were used. First, nine individual interviews were
communicating and maintaining birth cus-toms and rituals
conducted to hear the women’s voices and to seek their
in another culture are not easy. This is often because of
perspectives on their experiences through their own
the lack of understanding by caregivers of cultural
personal narratives. Building on the interview findings,
behaviors and responses, or the availability of the
the issues raised were discussed in detail with four
materials and support for traditional practices.
other women in a subsequent focus group.
In New Zealand, the population of Japanese has
Participants for the study were recruited by adver-
been rapidly increasing alongside other Asian eth-nic
tising and using a snowball technique. Only women
groups (Statistics New Zealand, 2013). However, the birth
who were born in Japan and currently resident in New
experiences of Japanese women in the New Zealand
Zealand and who had given birth within the last 3 years
maternity system have not been previously documented.
of the date of the interviews, or the focus group, were
Studies about Japanese birth experiences have been
invited to participate. A thematic analysis process, out-
done in other Western countries, such as the United
lined by Braun and Clarke (2006), was used to analyze
States and England (Yeo, Fetters, & Maeda, 2000;
the data. This method enables researchers to stay
Yoshida et al., 1997). In these countries, the women are
close to the data and identify the explicit meanings by
able to receive their childbirth care from Japanese care
simply organizing and describing the data (Braun &
providers, or care providers fluent in the Japanese lan-
Clarke, 2006). Transcriptions of the women’s
guage and knowledgeable about Japanese culture.
conversations were read and reread to generate initial
At the time of this study, the authors’ search of
codes from which patterns and themes were identified.
professional organizations, governmental agencies, and
Ethical approval for the study was granted by the
Japanese communities in New Zealand could not iden-tify
Otago Polytechnic Research Ethics Committee (ETHICS
any practicing Japanese midwives or obstetricians. The
470). This included consultation with the Kaitohutohu
way in which maternity care is provided in New Zealand
(Māori guardian) regarding any potential impact for Māori.
differs in several respects from the model of care in Japan.
For example, statistically, although 91.6% of the births are
registered with midwives in New Zea-land, only 4.9% of RESULTS
the main birth attendants are mid-wives in Japan (Japan
Ministry of Health, Labour and Welfare, 2013; New Demographics
Zealand Ministry of Health, 2012).
This study explores the Japanese characteristic and
The age of the women ranged from 32 to 42 years with an
desire to maintain harmony with others and with the envi-
average age of 37 years. The women were all born and
ronment. This desire to maintain harmony made it diffi-cult
raised in Japan and moved to New Zealand in their 20s.
for some of the women to express their needs related to
All had lived in New Zealand for a period of 2–19 years.
their cultural customs. The goal of this study is to assist
Eight of the women had married New Zealanders, and two
caregivers to realize the importance of these traditions for
had husbands from other Western countries. Three were
many Japanese women and to provide an environment
married to Japanese men. Eight of the women had one
within which Japanese women feel able to express their
child, and five women had between two and four children.
feelings and negotiate their cultural practices.
All their children were born in New Zealand with none of
the women having experienced birth in Japan. All the
women gave birth in hospital; 10 gave birth vaginally, and METHODS
3 had a nonelective cesarean section.
A qualitative research approach was chosen to give
voice to the women’s understanding of their birth
Results From the Interviews and the Focus Group
experience, and the qualitative description methodol-
ogy described by Sandelowski (2000, 2010) was used
Five themes emerged from the individual and focus group
as the fundamental framework for this study. Qualita-
interviews with the Japanese women regarding the keep-
tive description requires the researcher to stay close to
ing and performing of their birth traditions in New Zea-land.
the participant voices and not move far from the data.
They were (a) the value of Japanese birth ceremonies lOMoAR cPSD| 42619430
Negotiating Wa (Harmony) Doering et al. 29
and rituals, (b) the importance of keeping umbilical cords
It appeared that whatever the women’s lifestyle
as a keepsake once they had separated, (c) cultural cus-
and despite apparent lack of interest, those rituals
toms during the postpartum period, (d) how to take care of
seemed to take root in the mind of the women.
babies, and (e) dealing with cultural differences.
The Importance of Keeping Umbilical Cords
The Value of Ceremonies and Rituals
The idea of keeping the umbilical cord remnant, when it
There are some unique birth traditions in Japan that are
separated from the umbilicus, was quite common and
religion-based. Because the ceremonies or rituals are
taken for granted among the women. In fact, every woman
often fulfilled at shrines or with special materials, they
tried to keep their baby’s umbilical cord regard-less of their
are not easy to perform when not living in Japan. How-
religious beliefs or interest in Japanese customs. In Japan,
ever, most of the women in this study tried to practice
umbilical cords are valued as the fetuses’ vital lifeline and
these traditions when possible.
as the bond between mothers and babies, and it is
If a woman was unable to return to Japan for the
retained as a keepsake for a lifetime. Usually, umbilical
birth, her parents would practice the customs on her
cords once separated are wrapped with white paper and
behalf. For example, her parents would go to shrines in
put in a small wooden box. These are supposed to be
Japan and send omamori (charms for a good birth) and
taken by the children when they get married and to be
haraobi (traditional maternity girdles) to her. The women
cremated with them when they die.
highly valued these customary visits and items and the
support from their families. They always kept the charms
or amulets sent from Japan with them or in their bedroom
I have kept the umbilical cord in my ring case.
during pregnancy. Also, most of the women had visited the
Cases [for umbilical cords] are not given here,
are they? . . . My husband said, “Yuck!” and
shrines with their babies whenever they returned to Japan
told me not to keep it, but I told him Japanese
for omiya-mairi (a ceremony praying for the baby’s healthy
kept it, and so I kept it in the ring case nicely .
growth at a shrine 1 month after birth).
. . Umbilical cords are to be kept regardless. (Participant 6)
My mother went [to a shrine] instead of me, of
course. [She also got] haraobi from the shrine.
Despite their desire to keep the cords, two
She went to pray [for the birth] and got an oma-
women lost them when they fell off unnoticed. The
mori, too. I also went [to shrines] when I went
women regretted the loss and that they had not told
back to Japan during the pregnancy . . . You feel
you must do the customs, don’t you? . . . We can
their mid-wives that they wanted to keep the
never miss that. It is a must. (Participant 2)
umbilical cords. However, even when the women
told their midwives, the women and the midwives
My mother sent an omamori and I always
were not sure how to pre-serve the umbilical cords.
had it. I put all my prayers in the charm and I
was grasping it tightly all the time during my labor. (Participant 8)
When I was asked about the placenta, I said that I
did not need it but I wanted the umbilical cord.1 So
Moreover, even if the women mentioned they
we kept it, but it seems we made a mistake about
were not interested or said they did not do those cer-
how to preserve it. We did not know how, so we
emonies, each had followed at least one ritual.
put the really long cord on a plate in the
refrigerator. It became like bacon. (Participant 11)
No ceremonies . . . However, I went back to Japan
Although keeping umbilical cords is a common
last year. The time of omiya-mairi had passed and
we did not do (proper) omiya-mairi, but I supposed
practice in Japan and each woman in this study wanted to
it was omiya-mairi only in my mind when we
keep her own, how and which part of the cord to preserve
visited a shrine. I imagined omiya-mairi by myself
seemed to be a mystery to both the women and their
because my husband doesn’t understand these
midwives. In Japan, women stay in birth facilities for about ceremonies. (Participant 3)
1 week and the care providers manage almost all the
processes of keeping the cord until the mother is lOMoAR cPSD| 42619430
30 Negotiating Wa (Harmony) Doering et al.
discharged. However, most of the women in this study
were discharged within 1 or 2 days after childbirth, and
I see the different idea here. They think it is good
they were unsure of how to keep the umbilical cords.
to move, regain muscle strength, and go back to
Also the women had not always communicated their
the normal life as soon as possible . . . My hus-
desire to keep them to their care provider although they
band asked me why I did not mow the garden
wanted to participate in this tradition.
before a month after birth. (Participant 8)
People here actively leave the house
from the first day of the birth. So I wondered if
Cultural Customs in the Postpartum Period
Japa-nese hanging around in pajamas all day
looked strange when someone came to see
The Japanese place considerable importance on how
me. In Japan, it is natural. (Participant 13)
women should spend the postpartum period. The most
important custom is the long rest after birth. In Japan,
women are supposed to spend most of the time in futons
Having a shower soon after birth is also a major
(beds) with their newborn babies until tokoage (folding up
concern for women practicing Japanese customs.
the futon) occurs which is between 3 and 4 weeks after
There are other traditional taboos around showering
the birth. During this time, their mothers and family cook
such as avoiding the coldness including not touching
and do other housework. It is believed that women will
water, not washing hair, resting the eyes by avoiding
have severe menopausal disorders if they do not have
reading books and sewing. The ideas of restrictions of
enough rest after childbirth. This advice is frequently
these activities after birth were common knowledge for
handed down from mothers to daughters. all the women in this study.
In Japan, it is important for the family and care
providers to provide support for the woman so she can
Since when I was in the hospital, I was encour-
carry out this custom, and women whose mothers
aged to have a shower and to walk . . . followed
came to New Zealand to help had an easier time.
what they said and tried to have a shower and to
move as that sounded good. But after my mother
came, she told me not to move and asked me
My mother stayed here for 1 month and did all
why I was walking . . . Then my mother said that I
the housework for me. It was helpful, otherwise
should never move around. Even if I was fine at
you know . . . She told me, “The time after child-
the time, it would affect the menopause. I heard
birth is very important, so never move around.”
that from many people not only from my mother.
She did everything for the house. (Participant 2) (Participant 8)
On the other hand, it was very hard for women
The women tried to follow their mothers’
who did not have this assistance to maintain the
advice although they sometimes doubted it.
custom of complete rest for 1 month following the birth.
However, conflict occurred when unexpected
situations did not match their traditional values.
I moved around. I must have done all by myself.
[Women after birth] must rest in bed, mustn’t
People visited us [after birth]. Japanese
they? It was impossible for me. In Japan, it is
especially who had birthed said not to get up
said never to move, isn’t it? . . . I was not allowed
and left soon, but Kiwis [New Zealanders]
[to stay in the hospital longer]. No one helped me
stayed and some-times started eating meals
. . . I had no one to depend on. (Participant 3)
there. That made me so tired. (Participant 7)
I thought the Japanese custom of
staying in the bed for 3 weeks was right. I
was think-ing that I could move around soon
The women also felt pressure to conform to the New
at the first birth, but I found that the custom
Zealand custom of early ambulation and return to normal
was correct [from my experience]. Things
household roles. This expectation contrasted with the
told from ancient times are truly reliable.
Japanese tradition for resting after birth. A few respondents
That is what I have realized. After birth,
reported considerable stress from people expecting them to
women have to take a rest. (Participant 9)
resume daily routines such as cooking and housework. lOMoAR cPSD| 42619430
Negotiating Wa (Harmony) Doering et al. 31
To achieve a good rest after birth, satogaeri is
women and Western partners as well as different
a helpful tradition in Japan. Sato means hometown, cul-tural perspectives.
and gaeri means to return. So many women go back
to their own parents’ home when they have babies in
Japan. The good point about satogaeri is that they
How to Take Care of Babies
can get a lot of help from their mothers and have a
There are important cultural practices associated with
lot of rest. For the participants of this research, none
the care of babies following birth. First, many of the
did satogaeri. How-ever, a few women were
women were surprised to see tiny babies everywhere in
undecided at the beginning of their pregnancy, or
the town in New Zealand. It is believed by Japanese
regretted not going back to Japan when they were
that babies should avoid any stimuli including the
having a difficult time during the post-natal period.
sunlight and should be hidden from the public eye for 1
month. Because Japanese mothers are supposed to
rest at home approximately for 1 month, babies
I was hesitant [about giving birth in New Zea-
naturally stay home with their mothers. So although
land] because I guessed the way of birthing
they did not want to take their babies out at the early
might differ from country to country, and I was
stage, they had to struggle to accomplish that because
anxious about that. However, my husband
their husbands wanted to take their babies out for fresh
could not stay in Japan all the time . . . I
air or to show them off to friends.
thought it would be fine if only I was patient . . .
I thought it could be managed somehow.
Pregnancy is not a disease. It is a natural thing
I was surprised to see babies taken around
. . . However, the time after birth was
out-side. Babies are taken to the café, too. I
unexpectedly difficult. (Participant 6)
thought I could never do that. That is
It seemed that my husband could not
unimaginable for Japanese. (Participant 8)
understand satogaeri at the first birth. I
My husband wanted to take our baby
wished I could go back to Japan . . . But my
out. He really wanted to go and show the
husband said that he could not see the
baby [to his friends/anyone] . . . I made up a
baby’s face and that would be cruel to him if
reason of my own because I didn’t want to
I had had a baby in Japan. (Participant 9)
take the baby out-side. (Participant 12)
The support from their partners was necessary
How babies are put to sleep was also of
for the women giving birth far from their family and
concern to the study participants.
coun-try. Some partners were very helpful and
supportive, but not all partners provided support.
As bonding is important in Western culture, they
say that babies come to mothers’ arms directly
I became sad. I was alone after all. I had not
and sleep next to mothers in the bed after being
thought that because that [life without parents
born is bonding. Yet, I was surprised that they
close by] was my normal situation and my
put babies with monitors in other rooms sepa-
husband’s parents didn’t live close, either.
rated from their mothers and fathers. I thought
But I thought impulsively when I was filled by
which point of that was bonding? I thought “How
many things and lost my composure. “Why
cruel!” as compared with a Japanese way, which
doesn’t he [my husband] help me?” like that.
parents and children sleep together in the shape
He is the only one I can depend on here . . . I
of river “川.” (Participant 4)
should have told him. (Participant 8)
My husband opposed the idea of sleeping
with our baby. I told him that Japanese sleep with
children in shape of the character for river “川”
Statements such as “I should have told/asked
but he didn’t want to do that. (Participant 12)
him . . . , ” and other partner-related conflicts were
expressed solely from the women with Western hus-
bands. This cultural disconnect could be related to
Even in New Zealand where there is a wide range
different communication patterns between Japanese
of babies’ outfits, the women preferred Japanese-made lOMoAR cPSD| 42619430
32 Negotiating Wa (Harmony) Doering et al.
baby clothes. Many of the garments were sent from
Japan or handed down in the Japanese community.
Japanese friends envy me and say it is
good that children can grow in a free and easy
style here. It looks relaxed here for them . . . It
I could not believe the way they [New Zealand-
sounds strict in Japan, but I envy them in Japan.
ers] put on shirts from the babies’ head. I was
There are a lot of facilities and stuff of good
scared and could not do that. (Participant 8)
quality for anything. I say yours are good, and
My mother said that babies were warm so not
they say mine is good. We just want what we
to put many clothes on them . . . My midwife said
don’t have and envy each other. But I still think
“Babies need more!” and to put many clothes,
that the cir-cumstances of birth and childrearing
blankets and turn on a heater. I got scolded, but I
are better in New Zealand actually. (Participant 2)
did not know that. Well, that is a Japanese way and
babies are warm because they sleep with par-ents
in the same futon [bed] . . . My mother had to shut
In these ways, the women appeared to try and jug-
her mouth. (Participant 4)
gle the cultural differences by acknowledging that they had
chosen to live in New Zealand and that this required some
compromises and acceptance of differences.
Dealing With Cultural Differences DISCUSSION
The cultural conflicts regarding how to take care of babies
also occurred between the partners and the women’s
mothers when their mothers came to help from Japan. The
In contemporary society, with increasing moderniza-
women were caught between two people they loved who
tion, globalization, and international marriages, the
held different cultural perspectives.
degree to which traditional and cultural birth practices
Each woman managed these cultural differences
can be sustained is brought into question. However, the
in her own way. One woman tried not to care about the
women in the study clearly demonstrated that they val-
differences, whereas another told herself that “when in
ued their own cultural practices and attempted to take
Rome, do as the Romans do” (Participant 8). Another
the customs into their birth experience in New Zealand.
took only the things that she liked or that suited her
These customs include ceremonies, holding materials
from both cultures, whereas another felt she was wish-
for a good birth, keeping umbilical cords, how to spend
ing for something which does not exist here while
their postpartum period, and how to take care of their
enjoying the things that do. The women’s statements
babies. Yet, it was not easy for them to perform these
explain how they negotiated with themselves about
traditions outside of Japan. Sometimes, they needed to
what they experienced and how they dealt with the
modify the Japanese customs to fit their environment. cultural differences.
Sometimes, they just had to abandon some of the
ideas and practices they believed in.
The findings of the study reveal some of the dilem-
I think I have tried not to think of the gap.
mas, frustrations, and conflicts childbearing women, who
There is no use talking about the gap in
are Japanese and living in New Zealand, experi-enced
this situation . . . I was already here, so I
when they tried to practice their cultural birth traditions.
had no choice but to go through the way
However, some women were also pleased with aspects of
[they do it] here. (Participant 5)
the New Zealand ways such as a more relaxed
I tried to accept anything suitable for us
atmosphere in which to raise their children. It is important
regardless of differences between Japan and New
to note that although they enjoyed the New Zealand ways,
Zealand. However, we have firmly decided that we
they regretted that they were unable to also practice their
would never put the baby in a cot, say good-bye
Japanese birth customs. These tradi-tional birth customs
and close the door. Definitely. (Participant 4)
and perspectives about childbear-ing had significant
My family was far away, so I did not
have their support, of course. I wished I
importance for them and impacted on their experiences
would have. But I chose to give birth here,
and meanings of motherhood. This means that the
so there was nothing I could do. I just had
satisfaction of their childbearing experi-ence was partly or
to do without it. (Participant 13)
importantly affected by whether or not they were able to
practice Japanese traditions as lOMoAR cPSD| 42619430
Negotiating Wa (Harmony) Doering et al. 33
they wanted, and they attempted to complete their ideal
Japanese people tend not to show their emotions or
birth and parenting circumstances with their traditional
argue their ideas preferring to hold back their opinions and
belief. The attitudes and actions obviously showed that
avoid conflict considering that life is thoroughly connected
they needed to practice these to connect them to their
to the natural environment with which they coexist
Japanese culture while giving birth in another culture.
(Hashimoto, 2009). Hence, expressing “self” implies
The women in the study described their various
disturbing the harmony between themselves and the
feelings and reactions to their experiences and also
environment. The attitude that shows this view can be
noted that they dealt with their negative feelings by
seen in all aspects of life including motherhood. For
managing these internally. Most of the time, they did
example, one of the reasons for cosleeping is to breast-
not negotiate or discuss their concerns or dissatisfac-
feed the baby without disturbing the sleep of other fam-ily
tions with their partners or care providers. For example, members (Hashimoto, 2009).
when their partners encouraged the women to get out
To maintain wa, silence is particularly valuable in
of the bedroom and expected them to do housework
Japanese culture, whereas the spoken part of communi-
from an early stage following birth, the women felt sad
cation is more powerful in Western culture (Hashimoto,
that their partners held different views from their own,
2009). For Japanese people, silence shows politeness to
but they did not argue or negotiate.
others because it is the way to respect others and the
This reaction is shown in other birth experiences,
environment. Because Japanese people are more likely to
such as conflicts regarding care practices in differ-ent
be silent, they are also more likely to comply with the
maternity care systems between New Zealand and
directions or advice of health professionals. As a result,
Japan (Doering, 2012). This reluctance to express their
many of their difficulties and conflicts for the women in this
needs is possibly influenced by Japanese characteris-
study remained unresolved. In a study of Japanese
tics, and their behavior may be misunderstood when
women’s birth experiences in the United States (Ito
compared with the Western ways. Furthermore, the
& Sharts-Hopko, 2002), none tried to negotiate their
English language is unable to capture the exact nuance
cultural customs with the care providers. Ito and
of some Japanese words to discuss this issue.
Sharts-Hopko (2002) also point out that the reasons for
Therefore, how the women negotiated their problems
this is the Japanese inclination to play a passive role,
may only be understood in Japanese psychological and
and this is often complicated with the language barrier.
cultural terms. For example, harmony with other people
and the environment is often the first priority for
Japanese, and their attitudes show that they value this Akirame
belief. Thus, wa explains their behavior. By linking the
women’s behav-ior and responses to these values and
In addition to silence, akirame—renunciation or res-
language terms, the experiences of the Japanese
ignation—is also an important concept to help under-stand
women can be better understood by people from
Japanese behaviors. Akirame may be regarded as being
another culture including their Western caregivers.
the opposite side of the same coin with gaman—
endurance, patient, perseverance, or tolerance. Gaman
has been introduced into English in the original word with
Maintaining WA (Harmony)
wa by foreign journalists who were amazed to see the
patience and perseverance of the Japanese during the
Kunio Yanagita, known as the father of Japanese
Great Hanshin Earthquake in 1995 (Yoshizaki, 2003).
native folkloristics, stated that Japanese culture was
Japanese people believe they are supposed to
defined by wa, which means peace, total, harmony,
accept all aspects of the life—birth, aging, death, and
circle, or Japanese-oriented (Yoshizaki, 2003). One of
more—because human life is part of nature’s cycle in
the most well-known proverbs in Japan is “Wa wo
Japanese thought (Hashimoto, 2009). With this con-
motte tou-toshito nusu—Wa (harmony) is the greatest
nected understanding of nature and the spiritual con-
of virtues.” This is stated at the beginning of Article 1 of
cept of akirame, Japanese women might accept and
Japan’s first written constitution in 604 (Kanaji, 1986).
endure their experiences within the New Zealand birth
Okano (2003) argues that this constitution is the
context whether their experiences met their needs and
starting point of Japanese spiritual or moral identity.
expectations or not. This would include not feeling able
Since then, or even before then, maintaining wa has
to ask to have the opportunity to practice their tradi-
been an important part of Japanese culture. tional customs around birth. lOMoAR cPSD| 42619430
34 Negotiating Wa (Harmony) Doering et al. Kakugo
1997). As Ozeki (2008) maintains, accordingly,
Japanese women tend to conceal true or negative
Another key to understand the Japanese women’s atti-
feelings and often pretend to be cheerful even if they
tudes is kakugo—determination, resolution, and pre-
are seriously depressed. In fact, Yoshida et al.
paredness. The women had chosen to live in another
(1997) report that Western scales for assessing
culture and made up their minds to persevere through
postnatal depression do not work for Japanese
all kinds of experiences that accompany life there.
women, who do not express their feelings.
Every woman in this study had permanent residency
Behind their smile, they possibly experience
status in New Zealand with most determined to live out
much emotion and conflict. Japanese women,
their life in their adopted country.
who subconsciously seek to maintain harmony
A few of the women stated, “Childbirth is not a
with the local environment and culture, the
disease.” Childbirth is a normal part of their life, so
harmony with non-Japanese partners and the
having babies in New Zealand is a natural event for
family, and the harmony with the care providers,
them as long as they are living there. Giving birth in
may not be able to strongly show their emotions
New Zealand and accepting the ways that this occurs is
and articulate their own needs and desires.
the same as accepting the climate, housing, laws, and
the social systems of the country. When they chose to
live in New Zealand, they also had to accept living far
Reinterpreting WA for Cultural Safety
from their family in Japan. As a result, they could not
and a Positive Birth Experience
allow themselves to complain. They negotiated the
gaps between the two cultures with kakugo as well as
The abovementioned statement, “Wa (harmony) is the
akirame to try to maintain peace or harmony in their
greatest of virtues,” is generally understood by Japanese
mind and with their external environment.
and used as a caution to avoid fights and to respect oth-
Nonetheless, a Japanese worldview remains within
ers with peace, which includes restraining oneself to
the women even when living outside Japan, and they
achieve harmony for the group. However, it is said that the
continue to seek ways to feel comfortable with their
real meaning is to remind people to respect differ-ent
traditions, even if they have kakugo. Likewise, the tra-
points of views through lively debate but not to hold back
ditional Japanese thought originating from the religious
one’s idea or avoid argument (Kanaji, 1986; Okano, 2003).
influences of Buddhism, Shinto, and Confucianism is
Therefore, what it really means is that people should
naturally and unconsciously rooted in the women’s minds.
negotiate and try to understand one another by expressing
Even if they are not religious, or have become westernized
one’s opinion and listening to others’ to pro-duce a
or modernized, their worldview has a long history which is collective harmony.
not easily discarded despite their deci-sion to make New
Japanese women may need to be encouraged to Zealand their home.
express their emotions and opinions to others more
clearly and to talk about their wishes even though these
might not always be fulfilled. This may help ensure
The Risk of Trying to Maintain WA
emotional and mental well-being during their New
Zealand childbirth experiences. At the same time, they
Because of these Japanese worldviews, Japanese
should not worry too much about expressing everything
women may hold the conflicts to themselves. It seemed
they think and want in the verbal culture of the West
that most of the women in this study were only able to
because it is still natural for Japanese women to be
express their opinions to friends who were in the same
silent to avoid the stress of breaking the harmony. So
situation or in others who participated in this study.
main-taining a balance between expressing and
They had often tried to settle the issues with kokoro no
withholding and keeping a comfortable relationship with
motiyo—a condition of mind, or how to hold your
others are key issues for Japanese women.
heart—alone without discussion or negotiation with
Midwives’ roles are significant for building suc-
others. Despite the confusion and conflict that one may
cessful relationships and communication. The phi-
hold inside, Japanese people subconsciously com-
losophy of New Zealand midwifery practice is based on
municate with a smiling face or mild facial expressions
partnership with women which includes negotiation and
on the outside to not disturb the harmony with others,
shared responsibility between women and midwives
even when they are suffering pain or tragedy (Kagawa,
(Guilliland & Pairman, 2010). This sentiment closely lOMoAR cPSD| 42619430
Negotiating Wa (Harmony) Doering et al. 35
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