Protecting new life
through prenatal care

I pa'a ke kino ke keiki i ka lā'au.
The herbs build up the body of the child.
— 'Ōlelo No'eau

By Claire Ku'uleilani Hughes, Ph.D., R.D.

Hawaiian children are viewed as links in a chain of heredity and heritage from the ancestors. The newborn is connected to the ancestors as he joins the family. During their lifetime, children gather knowledge and skills, they apply the knowledge and skills as adults and gather wisdom, and then in death they rejoin the ancestors with increased mana. In turn, they become ancestors and perhaps even 'aumakua. In the ancient culture, respect for the ancestors and 'ohana, as well as the desire for a perfect infant, dictated special care during the prenatal period — a dictate that should continue today.

Mary Kawena Pukui tells us that there was much preparation in the family to welcome a new child. Senior women in the family paid close attention to the expectant mother's progress, assuring physical and mental development. They were watchful for signs of discomfort and potential problems during the various stages of pregnancy. Hawaiians believe that parental behavior affects the child's nature and character, and food cravings of the mother would indicate a child's nature. The culture's strict and exacting concern for a sound mind and physical body necessitated the special consideration for both the mother and baby during pregnancy.

A pale keiki or kahuna pale keiki, someone trained in obstetrics, would be engaged if the 'ohana did not have its own. The pale keiki's primary responsibility was to care for the expectant mother and carefully watch over her progress. In The Polynesian Family Systems of Ka'ū, Pukui writes: “Prenatal care was practiced long before the advent of Western medicine.”

The diet of the wahine hāpai was carefully supervised. In about the fourth month, special dietary regulations began. The expectant mother ate taro, sweet potato, breadfruit and a lot of greens. The greens were mainly lū'au, palula (taro and sweet potato leaves), pōpolo, and 'āheahea and seaweed. To avoid the difficulties of giving birth to a baby that was too fat, the mother was cautioned not to eat too much after the sixth month. During the last two months, she ate some 'ilima or hau tree flowers, which both act as lubricants. Mild ko'oko'olau or akiahala teas and plenty of fresh water were prescribed. Salty foods were limited. The mother-to-be was allowed very little raw fish and was given cooked fish. These dietary requirements were designed for the mother's health, but our ancestors knew that the unborn child would benefit as well.

This same dietary regimen is still very useful today. Greens, approximately three to five cups of cooked greens daily, provide vitamins A, C and generous amo-
unts of B vitamins, as well as the minerals calcium and iron. Modern science has linked a birth defect, spina bifida, to inadequate folic acid intake. We get folic acid from greens, fruit and whole grains. Inadequate iron is linked to iron-deficiency anemia.

The caution about gaining too much weight during pregnancy is still useful today. A number of serious problems and dangers occur when women gain too much weight during pregnancy, not to mention that the excess weight is difficult to lose after the baby is born. Many women gain more than the recommended 25 to 30 pounds.

Alcohol, cigarettes, drugs and poor food choices are major threats to the health of both the mother and baby. Smoking reduces the oxygen and blood supplies to the unborn child and can cause a baby to be born too small. It may even cause infant death. Alcohol can permanently damage the child's brain and physical development. Babies of parents (both) who use illegal drugs can be born too small, have serious heart problems or may die. An infant who is exposed to drugs while in the womb can suffer the pains of withdrawal, permanent nerve damage, and retardation. Use of over-the-counter drugs is equally responsible for serious complications. For example, aspirin and ibuprofen taken during pregnancy can cause problems for the infant or bleeding complications for the mother. All these factors threaten damage to the chain of heredity and heritage forever.

Becoming and being a parent is an awesome responsibility, and one cannot be cautious enough in protecting the new life.