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Philippine Daily Inquirer9 Feb 2011Michael L. Tan

THE HIGHEST number of births in the Philippines occurs in the month of September. That
has been pretty consistent through the years, which means the babies are mostly “made” in
December, the product of holiday cheer, maybe throw in a bit of the cold.

All that means, too, that during the first quarter of the year, we hear more talk about paglilihi
from those who got pregnant in December.

It was late last year when a new medical graduate, Gideon Lasco, asked me if there has been
research into the cultural aspects of paglilihi and my answer was, “Lots.” It’s a topic that
anthropologists love to explore because there’s so much here of biology interacting with
culture. I referred to some of the research in my book “Revisiting Usog, Pasma, Kulam” but
thought I’d expand the discussion into a column.

Paglilihi is sometimes loosely translated as morning sickness or pregnancy sickness. There is

nausea and vomiting as well as a heightened sensitivity in taste and smell, the world suddenly
becoming a less pleasant place to live in with all kinds of triggers (some women even claim
their own husband’s smell) bringing about the nausea.

Usually, these problems are not seen as serious, being triggered by the dramatic changes in
hormones during pregnancy. Two obstetricians, Samuel Flaxman and Paul Sherman of Cornell
University, have written many journal articles about this “pregnancy sickness,” proposing that
the vomiting is in fact the product of evolution, a form of adaptation, since these aversions
protect both mother and child from foodborne illnesses and toxins.

This pregnancy sickness is found throughout the world. One finding cited by Sherman and
Flaxman is that the foods most often avoided, across culture, are meat and fish. The two
obstetricians speculate that maybe this is because such foods have more problems of bacterial
contamination and that through time, pregnant women have “learned,” through culture and
concepts like paglilihi, to avoid them.

Paglilihi is not, however, just morning sickness. Filipinos often translate paglilihi as
“conceiving,” which itself offers a case study for anthropological investigation. In English,
“conceiving” is a misnomer because “conception” is associated with fertilization. Filipinos, on
the other hand, describe paglilihi as something that goes on for several weeks, often through
the first trimester of pregnancy.

I’m going to get back to these concepts of conceiving but let me first finish the description of
paglilihi. More than nausea, vomiting and morning sickness, paglilihi also refers to cravings
for particular foods, including those that might be difficult to find. If such cravings are not
satisfied, there may be adverse effects on the fetus and the pregnancy.
Still another important aspect of paglilihi is the idea that the physical features of the baby can
be affected by what the pregnant woman eats—or sees. Back in the 1960s, an American
anthropologist working in Dumaguete noted how pregnant women would go over to Silliman
University to stare at or even touch visiting American professors, hoping that some of their
features and, presumably, their “whiteness” would rub off on their offspring.

You can see now why the term “conceiving” is used because there is the idea that a fetus’
features can still be shaped by the mother’s diet, as well as visual environment during this

Obviously, there is no medical evidence to support this idea of transferring fair skin and
aquiline noses to the fetus simply by the mother’s staring, but there’s a whole new field now
of epigenetics which demonstrates how the environment can be as powerful as genetics in
determining a person’s future health. That can start as early as pregnancy: for example, a child
born out of a very stressful pregnancy could face higher risks of health problems like
hypertension and diabetes later in life, simply because as a fetus, it was subjected to constant
challenges, its body constantly on emergency settings.

The dietary cravings are intriguing. There is a physiological basis here, since a pregnancy
brings about increased nutritional needs, but researchers have not agreed on how these cravings
actually fulfill the needs. Many of the desired foods, for example, are not exactly nutritious
(e.g., pickles) in terms of protein or carbohydrates. On the other hand, various researchers
propose, the desired foods might provide trace minerals, or could balance out other potential
problems—salty foods reducing nausea, for example.

There is an important cultural component to explore in these dietary cravings. In 1963 the
journal American Anthropologist published an article by a Sri Lankan anthropologist, G.
Obeyesekere, about pregnancy cravings in Sinhalese women, a condition graphically described
as dola-duka, dola meaning an almost demonic craving, and duka meaning suffering.

As with our paglilihi, the cravings were for an assortment of foods, including sweets, sour
foods, as well as rare and expensive foods. Not fulfilling these cravings would result in a
problematic pregnancy. Obeyesekere had an impressive and elaborate discussion of the village
social structure to demonstrate a link between dola-duka and gender inequity.

Women worked long hours fulfilling many domestic duties, but had very low social status.
They were treated poorly, with little leisure time. There was violence by the men against their
wives, especially younger ones who supposedly had to be “tamed.”

In such a situation, a pregnancy became a break; men were forced to be kinder, if not solicitous,
including looking for foods the women wanted.

One can imagine something similar happening in societies like our own. During a pregnancy,
a woman is queen. She can banish her husband, complaining about his smell, and send him off
looking for santol when the fruit is not in season. Men also become more helpful with domestic

There are paradoxes in this paglilihi concept. On one hand, many Filipinos still think of the lihi
period as “dugo lang” (blood only) in a formative stage. On the other hand, all kinds of
prescriptions and prohibitions exist, showing that local culture does recognize how important,
and how precarious, this period is. The Department of Health, Unicef and other health groups
should look into how we can tap paglilihi to improve maternal and child health, for example,
getting men to be more supportive of their wives beyond the lihi period, if not beyond a
There is one last aspect of paglilihi which is rather sensitive. If a child does not look like the
father, the difference might be attributed to the mother having been “influenced” by looking at
the features of a neighbor or officemate (or a visiting foreign professor?) during the lihi period.
But such explanations generate tension, especially in this age of migratory work. If the husband
is frequently away from home, especially overseas, he and his friends will wonder: “Pinaglihian
o pinaglahian?”
1. What is the research about?
 It is about the Filipino belief in lihi. In Philippine folk culture, lihí is a
condition of pregnancy food craving in which a notable characteristic is that
pregnant women usually desire food such as sour, unripe mango with

2. In the research article, what were the cultural symbols of lihi as manifested to its
historical development?
 Lihi is an important cultural belief among Filipino that explain a number of
physical deformities. It is believed that an offspring will take the features of
food that the mother has carved for while she is in lihi.
3. Were there any biological element in lihi? Why or why not?
 No. the scientific studies prove that there is no link between paglilihi and
the unborn baby’s physical attributes. As genetics tell us, our physical
attributes are inherited from our parents’ and grandparents’ set of genes and
not from food craving.
4. Was the research helpful to the study of anthropology and how can be of interests in
field of nursing studies?
 Yes it was helpful to the study of anthropology.
 It the field of nursing practice it is important that to have knowledge and
skills of cultural awareness and influences in health in order to assess the
importance of client culture/ethnicity when planning , providing, and
evaluating care.
 Recognize cultural issues that may impact client’s understanding and
acceptance of psychiatric diagnosis.