Why Mothers Continue to Choose Traditional Birth Attendants as Birth Companions: A Qualitative Phenomenological Study in Rural Indonesia
Keywords:
Birth Companionship, Maternal Health, Qualitative Phenomenology, Traditional Birth AttendantsAbstract
Background: Despite efforts to promote skilled birth attendance in Indonesia, some mothers continue to choose traditional birth attendants (TBAs) as birth companions. Understanding the reasons behind this preference is essential for developing culturally responsive maternal health services. This study explored the factors influencing mothers' decisions to choose traditional birth attendants as birth companions in the working area of the Tete Community Health Center, Tojo Una-Una Regency, Indonesia.
Methods: A qualitative phenomenological study was conducted from May 24 to June 12, 2025, involving mothers who had been accompanied by traditional birth attendants during childbirth between January and May 2025.Data were collected through in-depth semi-structured interviews conducted in participants' homes, audio-recorded, and supported by field notes. Interviews were transcribed verbatim and analyzed using Braun and Clarke's thematic analysis. Trustworthiness was established through member checking, triangulation, peer debriefing, an audit trail, reflexive field notes, and rich contextual descriptions. Data collection continued until saturation was achieved.
Results: Five themes emerged as factors influencing mothers' decisions to choose traditional birth attendants: socio-cultural beliefs, psychological factors, family and social support, health service factors, and policy or regulatory factors. Strong cultural traditions, emotional comfort, family influence, perceived accessibility of traditional birth attendants, and limited policy implementation contributed to mothers' preferences.
Conclusion: Mothers' decisions to choose traditional birth attendants are influenced by interconnected cultural, psychological, social, health service, and policy factors. Strengthening culturally responsive maternal health services and enhancing collaboration between healthcare providers and traditional birth attendants may improve the utilization of skilled maternal healthcare while respecting local cultural values
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