Mothers' experiences during prenatal and childbirth journey in Bali: a qualitative study

Indonesia has made substantial progress in reducing maternal mortality, with the Maternal Mortality Ratio (MMR) declining from 446 per 100,000 live births in 1990 to 305 per 100,000 live births in 2015 [1]. Nevertheless, further improvements in the quality of maternal healthcare are needed. This study sought to investigate the experiences of Balinese mothers and their perceptions regarding care during pregnancy and childbirth.

We used a qualitative descriptive study design with in-depth semi-structured interviews to explore experiences of Balinese mothers and their perceptions of the perinatal care they received during pregnancy and childbirth. Nineteen Balinese women who had given birth in Bali were recruited for the study. Data were collected from August 2017 to January 2018 in Badung Regency, Gianyar Regency, Karangasem Regency and Denpasar City in Bali Province and were analysed using the qualitative content analysis method.

The analysis revealed one core category, "Mothers' preferences and aspirations for childbirth," and four major categories that characterize Balinese mothers' experiences. The core category highlighted the importance of acknowledging women's wishes in shaping positive birth experiences; mothers felt supported and confident when respected. The four major categories were: desire for a convenient and comfortable birth environment, support from community midwives, dissatisfaction with hospital care, and the stages leading to childbirth. Balinese women typically choose hospitals for delivery due to the availability of superior facilities, yet they frequently reported dissatisfaction with the attitudes and communication of health professionals. Furthermore, a significant lack of maternal knowledge and empowerment was observed, with many women tending to passively accept medical recommendations.

Although mothers preferred hospitals for safety, many reported dissatisfaction with poor communication and negative attitudes from health professionals. Strengthening respectful communication, supporting shared decision-making, and expanding midwife-led, culturally sensitive care may enhance maternal satisfaction and birth experiences.