Who makes the decision?

One of the things that I've discovered, especially since working at the birthing home, is that in this culture (and apparently most South Asian cultures) the mother-in-law rules the roost, big time. If a mother-in-law tells her son's daughter that she needs to wear socks for the first 3 months after giving birth so she doesn't catch a chill and get sick, she doesn't question, she obeys. Or that she's too stressed out and her breastmilk is spoiled so she needs to formula feed, she obeys. Or that evil spirits might enter the baby through it's umbilical cord stump if it's not tightly wrapped with a belly-band, she obeys.
I don't want to give the impression that mother-in-laws are evil, because they're not. But they are mostly uneducated and uninformed. Tradition is truth and fixed.
In a recent article by the Royal College of Midwives, a Nepali midwife conducted a survey and discovered the same thing. The mother-in-law makes all the decisions, including the need for prenatal care, the household jobs that must be done while being pregnant, who delivers the baby, and much more.
Often the very young moms at our clinic come with their mother-in-law. This actually makes me very excited! It means I can respectfully teach the new mom with the "old" mom. I try to always ask if the mother-in-law breastfed her kids and for how long, who delivered her babies, and if SHE has any questions for me. These are my favorite teaching times because I feel like there's a better chance that what I teach might make a difference.
It's amazing to me how much CULTURE influences healthcare. I could have all the right training and techniques, but unless I am able to successfully put it into the correct culture context, it's useless. I'm so thankful I have 18 years logged in this culture, but at the same time I'm very much aware that I have much more to learn!