Rantau Bertah

While the elephants may have been the highlight of Minas, we still have three more days of interviews. We traveled to Rantau Bertah, which was about an hour outside of Minas on a pretty bad road, but a beautiful drive. The second half of the drive was through a heavily wooded area which I later learned belonged to a paper company - I'm hoping it'll remain beautiful for a long time. We had planned to visit a Mother's Group of pregnant women but when we arrived they hadn't yet started their meeting, so we instead headed over to a posyandu which was overflowing with women coming for their ANC checks and baby weighings. This is definitely a day I would have loved to have been a fly on the wall - with my Nikon, of course - but per usual, we were shuffled into a back room and set up for interviews.

Village health worker noting the growth progress of a baby on her growth chart

Village health worker and posyandu-goers

The antiquated baby scale that I'm certain does not produce accurate weights. And for once, I think this system of baby/children weighing is worse than the system in Mali.

We started our interviews and got many more than we had initially planned. I'll share two stories that highlighted the day in Rantau Bertah. The first is a woman, in her mid thirties who only received an elementary school education, told us about the great relationship she has with the midwife at the puskesmas. She stayed at the puskesmas for both of her births and said that she'll return there for any subsequent births as well. Despite being relatively poor, she didn't care about the costs of childbirth or anything else - she loved her midwife and wanted to be safe.

Surprising me beyond everything, this woman - with an elementary school education only - has given birth at the puskesmas twice. It proves that education level isn't the only determinant to facility-based birth, but that a woman's relationship with their health provider is greatly important.

After meeting here and hearing about her experience with the village midwife, it was great to hear that midwives are more than just baby catchers and that women feel a real connection with them. These midwifes likely offer advice and other pregnancy and birth related services. They also likely provide friendship. After having this wonderful picture painted for me of a midwife who really cares about her patients, we met our next mother. Unfortunately, this woman had possibly the worst experience with the same midwife. As she stood and bounced her newborn to avoid crying, she answered our questions and interjected her story along the way. She planned to deliver at the puskesmas and when she began to have labor pains, she walked to the facility (maybe a km or so). When she arrived, she was 6 cm dilated, but the midwife told her she wasn't ready to deliver and that she should go home and come back when it progressed. As soon as she arrived back at home, her labor pains were worse and she sent a neighbor to bring the midwife to her house. She said that when the midwife arrived, she was annoyed that she had been bothered to come after just sending the woman home. She delivered the baby, but at the same time left the mother with a terrible birthing experience.

This little girl has such a full head of black hair - she was the first infant I saw with so much hair.

Two conflicting accounts of the same midwife. Interesting how two experiences can be so different. It's also a shame that one woman had such a terrible experience that perhaps next time she is pregnant, she'll choose a traditional birth attendant to help her deliver instead of feeling disrespected by the village midwife. For her, I hope she'll take into account her safety and that of her baby, or the fact that the midwife at the puskesmas can handle simple complications that a TBA cannot. It was at this point that I ran into an ethical dilemma. Part of our research asks questions about how women are treated during their stays at facilities. With such a negligence of duty by this midwife, and not knowing if other women have had similarly poor treatment, I'm compelled to report it someone. However, I was told by more than one person that it's not my responsibility and that it's a tricky road to go down. So instead, we leave a midwife of questionable work ethic in place and do nothing. Not an easy situation.

A happy mom and health baby girl with pierced ears

Sign in the posyandu saying:
"Come to the posyandu. Keep Children Healthy. To determine the growth and development of children." And was created by the Health Promotion Improvement Project of West Sumatra in 2001

I know I said I only had two stories, but as I was writing I remembered a third. After we finished at the posyandu, we headed over to the Mother's Group - remember, the original reason we came to Rantau Bertah? - and talked to a few pregnant mothers. In this small village we found a university educated woman who I believe was a teacher. She was very petite, but I remember her being very stunning as well. Throughout the course of our conversation with her, we found that she planned to stay home to deliver her baby. I was shocked and probed a little bit more to find out. Turns out - which has actually been the case in a lot of our interviews - that she was planning on staying home to be close to her family and because it was more comfortable. She said that the only way she would go to a facility would be if her entire family could come and stay with her throughout her stay, until she was discharged.

I enjoyed Rantau Bertah, but it proved that there are always surprises around the corner.