Understanding the influence of cultural practices on maternal health is crucial in addressing the nutritional challenges faced by pregnant women in rural Bangladesh. Despite significant improvements in maternal and child health indicators, food taboos remain prevalent, impacting the nutritional well-being and health outcomes of vulnerable populations. This study explored food taboos and factors related to their adherence or violation, among rural pregnant women in four districts of Bangladesh: Habiganj, Bhola, Rajshahi, and Cumilla. A qualitative cross-sectional study was conducted with 90 participants through 29 in-depth interviews and 11 focus group discussions. Participants included 21 pregnant women, 23 mothers-in-law, 20 husbands, and 26 healthcare workers. The data were thematically coded and the narrative was analyzed. All participants identified at least one food item restricted by family elders, often based on beliefs about the negative effects of certain foods on pregnancy and the baby's 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 preference for vaginal delivery, desire to avoid harm to her child, and profound respect for her elders. Factors enabling the breaking of food taboos included nutritional counseling by health care workers, increased family understanding of maternal nutrition, reduced reinforcement of taboos, and the lack of negative consequences from consuming tabooed foods. The findings highlight the importance of utilizing scientific evidence to challenge food taboos by developing new strategies or updating community-based nutritional counseling programs. Furthermore, including family members and community elders in these efforts is crucial for creating a conducive environment that facilitates dietary changes for pregnant women.

The authors have declared no competing interest.

This work was supported with the aid of a grant from Nutrition International, Ottawa, Canada through the financial assistance of the Government of Canada through the Global Affairs Canada and other generous donors (NI File number: 10-1659-UBANGA-09). NI had no role in the design, analysis or writing of this article.

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This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving research study participants were approved by the Institutional Review Board of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh (BSMMU/2017/3281). Written informed consent was taken from all the participants before commencing the interviews. Utmost care was taken to ensure the comfort of the pregnant women and their children by the data collectors. Sensitive questions or issues were dealt very carefully without hurting the sentiments of the participant and their family. All the members of the data collection team and analysis team cautiously maintained the confidentiality and anonymity of the participants throughout the study.

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