Qualitative research for the social marketing component of the perinatal regionalization project -- Tanjungsari West Java

The study found that pregnancy is generally not viewed as a debilitating condition or one requiring much change in daily lifestyle. Pregnant women use both formal and traditional health care. Formal care is provided by trained midwives and doctors at polindes (village birthing huts), health centers, and hospitals, and most women are examined by a midwife at least once during their pregnancy. Traditional care is provided by TBAs or mantris (untrained paramedics) in the village; TBA care is sought by almost all women from the seventh month of pregnancy until 40 days postpartum. Labor is normally viewed as a fairly easy process, and women strongly prefer home births attended by a TBA and family members. Respondents have somewhat ambivalent views of the polindes. While polindes are valued for their access to a midwife or doctor, many women are uncomfortable with the placement of some polindes in the home of the village chief or in the village office, and do not like the fact that their small size prohibits the family from attending the birth. Cost, embarrassment, and inconvenience weigh against using the polindes for delivery. Costs are also an obstacle to compliance with referrals to hospitals or health centers for prenatal care or delivery. Most respondents said they would comply with a referral only if they were convinced it was necessary to save the baby or mother. The report includes recommendations for providing perinatal care in the study region. (Author abstract)