Mothers, midwives, and modern medicine : an analysis of choice in the birth experience, South Sulawesi, Indonesia

Includes bibliographical references (pages [96]-100)Indonesia has a thriving population of traditional birth attendants, known as dukun beranak, and midwives, known as bidan. Dukun beranak annually help deliver over 65% of Indonesia's newborn children but with limited success: one in 250 mothers and fifty-eight in one thousand infants die annually in Indonesia. The Indonesian government is attempting to solve the crisis of maternal and infant mortality in part by placing bidan in every village. Although the government's program could potentially decrease these high mortality rates, women continue to call on dukun beranak for childbirth assistance. Literature concerning the interface between traditional and cosmopolitan midwifery in Indonesia is scarce, and therefore an adequate explanation does not exist to describe why women consistently choose dukun beranak over bidan. This thesis, based on fieldwork conducted from August 1995 until January 1996, presents the criteria women use for choosing childbirth assistants in Banyorang, South Sulawesi, Indonesia. Three explanations of bidan utilization are assessed, and two revised explanations of childbirth assistant utilization are proposed. This thesis proposes that some women in Banyorang have developed a childbirth assistant utilization hierarchy that not only demonstrates their awareness of infant and maternal mortality, but also maintains their autonomy, conforms with their beliefs, and is relatively inexpensive. In this hierarchy traditional and cosmopolitan medical systems are integrated so that women and their children have a better chance of survival in a country where infant and maternal mortality is extremely high.M.A. (Master of Arts