Motivators for Adherence and Drivers of Taboo-Breaking Behaviour Regarding Food Taboos Among Rural Pregnant Women in Bangladesh: Findings From Formative Research.

Understanding the influence of cultural practices on maternal health is crucial in addressing the nutritional challenges faced by pregnant women in rural Bangladesh. Despite improvements in maternal and child health indicators, food taboos remain prevalent, impacting nutritional and health outcomes of vulnerable populations. This qualitative study explored food taboos and factors related to their adherence or breaking, among rural pregnant women in Bangladesh, where a total of 90 participants, including 21 pregnant women, 23 mothers-in-law, 20 husbands, and 26 healthcare workers, were interviewed through 29 in-depth interviews and 11 focus group discussions. Nearly half of the participants adhered to food taboos, citing beliefs about their negative consequences on pregnancy and baby health. Commonly restricted animal source foods included white carp, trout, duck meat, and mutton, due to fears of convulsions, speech disorders, or undesirable traits in the baby. Raw papayas and pineapples were avoided due to beliefs they could cause miscarriage. Adherence to these taboos was related to the pregnant mother's desire to avoid harm to her child, preference for vaginal delivery, avoid financial stress of caesarean section, profound respect for her elders, early age at marriage, and primiparity. Factors enabling the breaking of food taboos included nutritional counselling by healthcare workers, increased family understanding of maternal nutrition, reduced reinforcement of taboos, and the lack of negative consequences from consuming tabooed foods. The findings underscore the need to use scientific evidence to challenge food taboos by enhancing nutritional counselling programmes and engaging family members and community elders to foster dietary changes for pregnant women.