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Birth philosophy and experience based on birth place: an ethnographic study in Indonesia

02 February 2025
Volume 33 · Issue 2

Abstract

Background/Aims

A woman's childbearing philosophy and the birth environment's paradigm will affect her experience of birth. This ethnographic study aimed to explore the interaction between birth philosophy, place of birth and birth experience.

Methods

Interviews were held with 16 postpartum women at hospitals and public health centres, conducted at 1 week and 42 days postpartum. Observations were also taken on implementation of birth in both settings. Data were analysed thematically.

Results

Participants viewed birth as a medical problem that required assistance from healthcare professionals. The health system supported technocratic childbirth, particularly as a result of the referral system, which eliminated midwives' role in providing a natural birth.

Conclusions

The healthcare system should prioritise women's comfort during birth. Women should be given information about natural birth during antenatal care, and healthcare professionals should avoid behaviour that encourages women to give birth technocratically.

Implications for practice

Private midwives need the opportunity to provide independent services, and midwives need training on women-centred care. Birth planning could be used to increase women's capacity and authority over their bodies.

Literature has shown that birth place has an important impact on the process of birth (Walsh, 2000), as it influences women's comfort, assurance and control over their bodies (Niles et al, 2023). Gould (2002) argued that a hospital environment fosters a birth procedure defined by a comprehensive medical approach, while Walsh (2000)noted that ‘bed birth’ affected women's mobility. Several factors are known to contribute to a positive birth experience, including an appropriate temperature, floor coverings, comfortable pillows, privacy, control over the presence of a birth companion, the freedom to have food and drink, access to a birthing pool and easy access to a toilet (Walsh, 2000). Nevertheless, the use of these elements in birthing centres worldwide remains infrequent (Niles et al, 2023).

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