Exploring Women's Reasons for Choosing Home Birth with the Help of Their Untrained Family Members: A Qualitative Research.
Nila Kusumawati, Erlinawati Erlinawati, Yenny Safitri and 2 others
PMID 37114100WHAT IT FOUND
Migrant women in remote Indonesian areas chose home births with untrained family due to language barriers, cultural isolation, and lack of insurance.
They viewed family assistance as safer and more private than facility care, which they found inaccessible and alienating.
Key findings
01Women relied on untrained family members because they felt socially alienated from the local community due to language differences and religious practices, fearing discomfort and misunderstanding if they sought help from strangers.
02Practical barriers including distance, poor road conditions, lack of transport, and inability to afford out-of-pocket costs due to lack of health insurance made facility childbirth inaccessible.
03Participants believed childbirth was a normal physiological process where complications were manageable by family, and that death was destiny, leading to negative perceptions of safe motherhood programs.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was homogeneous, consisting only of Nias ethnic migrants in one province, so findings may not apply to other ethnic groups or regions. Data were collected via telephone interviews, which may have missed non-verbal cues and contextual details of the home environment. The study relied on self-reported reasons for past events, which may be subject to recall bias. The covert nature of unassisted childbirth makes it difficult to recruit a representative sample, leading to potential selection bias.
Declared interests
Funded by the Ministry of Research, Technology, and Higher Education, Republic of Indonesia. The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret these findings as evidence that home births with untrained family members are safe. The study reports women's perceptions and reasons for choosing this path, not clinical outcomes. The authors explicitly note that maternal mortality is a public health issue in this region, and these births are associated with significant risks that the participants underestimated.