J

span class="caption" style="width: 398px;">JP/Luh De SuriyaniThe campaign for gentle birth and the importance of exclusive breastfeeding in Bali regained momentum with the nomination of an American-born midwife as one of the CNN Heroes this year.

Hemmerle Robin Teresa Jehle, known as Robin Lim, has spent decades in Bali teaching how gentle birth and exclusive breastfeeding are crucial for the growth and development of babies.

She gathered public support to educate young midwives responsible for mothers and newborn babies, not only in medical treatment but also through affection and non-discriminatory services.

“With the support from our donors, the Bumi Sehat clinic will continue to educate young midwives to contribute to the better quality of future generations in their respective areas,” said the 55-year-old Lim, who runs the clinic.

Her clinic has presented scholarships to 11 women to study midwifery in several schools.

“These new midwives should be willing to be assigned to their respective areas to help mothers give birth to their babies with affection,” she said, adding that she expected more donors to support this scholarship program.

Lim said the campaign for gentle birth and exclusive breastfeeding faced more challenges today, with a lack of support from doctors to help mothers deliver their babies naturally and massive commercial activity by formula milk industries targeting hospitals and birth clinics.

Her clinic in Ubud welcomes pregnant women that cannot afford to deliver babies anywhere else, as well as those who need full support for gentle birth methods and exclusive breastfeeding. Many foreigners and expatriates also come to the clinics to deliver their babies.

“Here we have some alternatives for gentle birth, including water birth and other methods that our patients can choose,” Lim said.

“Some foreigners are willing to pay a greater amount of money than they are normally charged in their countries so we can apply a cross-subsidy method for poor patients.”

Every year, the clinic helps some 500 women give birth, including at its Aceh branch. The clinics also welcome foreign midwives and medical officers as volunteers.

Ni Wayan Karti Sutarjana, a senior midwife and advisor for the Indonesian Midwives Association in Bali, said the government has given its full support to increase the rate of normal births by applying free-of-charge delivery in clinics and hospitals.

“Caesarian sections should only be applied when they are critically needed. We don’t expect doctors to recommend that method to their patients.”

The main problem of the health and safety of pregnant mothers in Bali is the lack of midwives in remote areas, she said.

“In my village in Besan, Klungkung, the ratio between midwives and patients is 1:300. Ideally, it should be 1:10.”

Millennium Development Goals (MDG) data from Bali’s provincial development agency showed that the infant mortality rate in Bali was 34 per 1,000 lives, while the MDG target is 24 per 1,000, expected to be achieved by 2015.

Regencies with high infant mortality rates in Bali are Karangasem and Jembrana, above the national rate of 36 per 1,000.

According to the data, the most common cause of infant deaths is low birth weight, accounting for 41 percent or 188 cases, followed by pneumonia and asphyxia.

The MDG data only showed the infant mortality rate in 2007, which is 228 per 100,000 live births, while the MDGs target is 100 per 100,000. The percentage of mothers giving birth with the help of trained medical officers is 96 percent, but there are disparities among regencies.

Regencies with high maternal mortality rates are Karangasem, Bangli, Jembrana and Klungkung, mostly caused by heart and respiratory diseases as well as HIV/AIDS symptoms.