An Examination of the Variables Affecting the Decision to Choose a Birth Attendant during the COVID-19 Epidemic

Abstract

Maternal and Child Health (MCH) remains a significant health issue in Indonesia. The Maternal Mortality Rate (MMR) remains high, with 305 deaths per 100,000 live births annually. One contributing factor is the inadequate coverage of skilled birth attendants, which nationally reached only 88.68% in 2014 below the government target of 90%. This study aims to identify factors influencing the choice of birth attendants among mothers during the COVID-19 pandemic. This qualitative descriptive case study involved three purposively selected informants: a midwife, a mother who gave birth at the health center, and a mother assisted by a traditional birth attendant (TBA). Data collection was conducted through in-depth interviews and documentation, and analyzed using data reduction, data presentation, and conclusion drawing. The study found that low knowledge, strong trust in TBAs, low income, and limited education influenced mothers’ preference for TBAs over healthcare professionals. TBAs were perceived as more affordable, further reinforcing their role. The study recommends that health workers increase promotion of skilled birth attendance through health education activities such as at Posyandu and women’s groups (PKK), and build community trust. Collaboration with local government is crucial to ensure TBAs coordinate with health personnel. The study concludes that deliveries attended by healthcare providers are still below the 100% national target. It is advised that village midwives work closely with local health cadres to track pregnant women and provide comprehensive antenatal care and ensure the use of MCH handbooks.