While women around the globe are actively planning to have an intervention-free, drug-free labor, women in Jakarta are opting for exactly the opposite. Della (not her real name) aged 26, is one of these women. She was told by the doctor she could have a normal vaginal delivery if she wanted to, indicating that she had the options to do otherwise.
Making a decision based on personal judgment and very little fact-based information, Della decided the date on which she wanted to see her little bundle of joy. So on the seventh day of August 2009 which reads 07-08-09 on a digital calendar, the baby was born.
Anissa (not her real name), aged 25, has a different story to tell. She has been reading a lot of information on giving birth and she has been preparing herself physically and, most importantly, mentally to have a natural birth on the day her baby is ready to be born. During her weekly checkup with the doctor, she was told her baby needed to be delivered right away, given the circumstances.
Without any second opinion, she went straight into the operating theater, even before her family had arrived at the hospital. A few days later, Anissa was finally able to overcome the disappointment of not being able to give birth naturally.
She added it would have been better for her to know she was going to have a caesarean section from the very beginning, than to have gone into labor and been given the verdict halfway that she had to have a caesarean.
Such ways of thinking are becoming all too common among pregnant women in big cities nowadays. The scary stories of vaginal births far outnumber the success stories, and this has created a significant distortion in public perception about the advantage of natural versus caesarean birth.
There is very little information for Indonesian mothers on how natural birth can benefit both mother and baby, especially given by their preferred healthcare professionals. Although nationally the rate of caesarean births in Indonesia is still considered low (probably because the only people who have the option of having a C-section are the affluent ones), one media has announced one of every two mothers are now electively choosing to have a C-section. It is beyond comprehension that mothers can now choose whether to have a natural birth or a C-section with no clear reason other than chasing a pain-free labor, to get a special birth date for their child, or even to declare their social status. Most pregnant women may not know that a C-section poses a series of threats to the mother.
Private hospitals or clinics, assumed to provide an educated service compared with their public counterparts, are faced with the dilemma of promoting natural birth or getting more revenue. It is apparent that when performing C-sections, doctors will receive extra fees and this is the very loophole within the Indonesian healthcare system. Healthcare professionals ideally suggest what is best for their patients, as opposed to what is "convenient". This requires a separation of authority between doctors who evaluate patients' health and those who perform the operations, and a mechanism to monitor the performance of the two.
It is about time the government have a formal say on the matter, before caesarean sections becomes a common thing and giving birth is just matter of selfish convenience and digging deeper into the patient's pocket.
Kanti Pertiwi
Jakarta
