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Pregnancy

Family decision making for Madurese women with pregnancy complications: a qualitative study

02 April 2024
Research
02 April 2024
Volume 32 · Issue 4

Abstract

Background/Aims

A delay in referring women with pregnancy complications to medical care is a significant contributor to maternal mortality worldwide. In Madura, Indonesia, these delays can be exacerbated by the role of a woman's family in decision making. This study aimed to explore family decision making in seeking healthcare for women with pregnancy complications in Madura.

Methods

Using a descriptive qualitative approach, in-depth interviews were conducted to explore the decision-making experiences of 12 pregnant women, 12 of their family members and 10 midwives.

Results

Three themes were identified: women empowerment issues, cultural factors, and important considerations in seeking healthcare for women with pregnancy complications.

Conclusions

Continuous health education is needed to increase knowledge of appropriate maternal care for pregnant women and their families. The involvement of religious leaders in programmes to enhance referral decision making would be beneficial.

Approximately 15% of pregnant women will develop complications, which can result in maternal and fetal death (Noviani et al, 2020). Delays in referring pregnant women with complications for medical care remain a significant health service issue, particularly in developing countries (Sahoo et al, 2021). Delays in accessing and receiving appropriate medical care result in maternal and neonatal morbidity and mortality (Carvalho et al, 2020). Improving referral systems is an important strategy to reduce maternal mortality ratios.

The Indonesian Demographic Health Survey reported that in 2017, Indonesia's maternal mortality ratio was 305 per 100 000 live births (National Population and Family Planning Board et al, 2018). The United Nations' (2015) Sustainable Development Goals aim to reduce the global maternal mortality ratio to less than 70 deaths per 100 000 live births, with no country having a ratio higher than 140 per 100 000 live births by 2030 (Kementerian Kesehatan Republik Indonesia, 2018). In light of this target, efforts to reduce the maternal mortality ratio in Indonesia must be optimised.

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Family decision making
Health-seeking behaviour
Maternal health
Pregnancy complications