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Women’s health at threat from discrimination

Discrimination, poor access to services and lack of information about healthy pregnancy make Indonesia’s rate of child-birth linked deaths one of the highest in Asia, a World Bank report finds.

Every year at least 10,000 women die from birth complications in Indonesia, the report finds.

That’s because many women in the mostly Muslim nation often lack the status or money to make important decisions about their own treatment, says Masruchah, secretary-general of the National Commission on Violence against Women.

“There's a view that husbands should have final say over domestic matters, but men often don't know what their wives feel,” he told United Nations news service, IRIN.

“Pregnant mothers are often too late in identifying danger signals during pregnancy and in making decisions, because women often have to wait for their husbands or parents to make decisions,” said Linda Gumelar, Minister for Women’s Empowerment and Child Protection.

Taxi driver Muhammad Juhri made the choice that his pregnant wife would have a normal delivery, against the doctor’s advice she had a Caesarean section because of her high blood pressure. Though the baby was safe, the mother died of complications.

On the south east Asian group of islands, a C-section costs about £1,000. “The maternity hospital suggested a C-section, but I didn't have the money,” said Juhri, who works in Jakarta suburb Depok. “I took her to a midwife, but she could not handle the delivery.”

Age, level of education and how well off they are all affect a woman’s birth and maternal health, the report says. Home births and the use of birth attendants make matters worse – the study shows that only 10 per cent of poor women in two districts of the country’s West Java province have a health professional there when they give birth. And only 40 per cent of the country's 68,816 villages had a midwife in 2005, it found.

Outdated practices and myths about pregnancy often hamper quick medical intervention, said Sutan Finardhy, an obstetrician-gynaecologist in rural Indonesia. Family members and even neighbours often advise against medical treatment for pregnant mothers. “In some cases, husbands agreed to a doctor's advice, but parents insisted on taking the mothers home or resorting to traditional means,” the medic said. “By the time the mothers had access to medical intervention, it was already too late.”

The report calls for improved training, more obstetricians, gynaecologists and anesthesiologists, and more money into overall funding for maternal health across the country.

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