‘Midwifery in Bali’ Reflection

I didn’t quite know what to expect when I applied for this experience. Was I going to be delivering babies in rural areas with little resources? Was I going to spend the day with a Balinese midwife? Was I going to see and learn midwifery in a different culture that would change my approach in my practice? Well, this trip was certainly not what I expected however was filled with valuable and memorable moments and below are my thoughts and reflections.

Day one we arrived at Rumah Sehat Madani Clinic, a local birth centre in Denpasar. The midwives were warm and welcoming. We were given a presentation on the centre and some key aspects of midwifery including gentle birth. We then had a tour of the facilities there. I love that this clinic are practicing ‘grass roots’ midwifery and it reminded me of the power of birth and to have as little intervention as possible with women in labour. The facilities were basic, however, they had all the essential resources they needed and it had a very ‘home-like’ environment for women to birth in which I believe we need more of in Australia.

We continued on to visit Yayasan Rama Sesana, a not-for-profit reproductive health clinic based in the heart of the local markets in Denpasar, which has been operating for 11 years. When we arrived we had a presentation of the work that the clinic do and how they serve their local community. We then had a tour of the markets and saw their volunteers in action. I was so impressed by their work. They are educating women in their workplace to change health outcomes. It reminded me again of how important education is and how it empowers women and changes a community.

On day one we visited a private hospital, Kasih Ibu General Hospital and the next morning we saw a provincial public hospital, RSUP Sanglah Hospital. We were given presentations on their facilities and services as well as a tour. The standard of these hospitals was far greater than I had expected. They had all the resources that we have access to in Australian hospitals. We discussed midwifery care that was provided which was not dissimilar to the care we provide in Australian hospitals. They had a huge focus on breastfeeding however the mother did not always room in with her newborn. They had high rates of natural birth and low rates of caesarean and instrumental births. Sadly, they are striving to become ‘more like Australia’ however my fear is that perhaps this means higher intervention rates. They need to embrace the ‘natural birth’ culture that is present in Bali. I loved seeing the neonatal intensive care units in these hospitals. Again, I was impressed with the resources and level of care. It was evident that they deal with many different diseases and abnormalities than we would in Australia, mainly HIV/AIDS.

Day two we also visited the Midwifery Academy of Kartini Bali, the university where midwives are educated. This was a huge cultural experience. We walked into an ‘International Seminar’ with traditional Balinese music, dancing and dress. Here, the head of the university as well as the head of Midwifery in Bali spoke. Our own, Dr. Christine Catling was the guest speaker. Again, education is quite similar to Australia however you must be under the age of 25 to be eligible for the course.

My favourite place we visited was on day four where we went to the Bumi Sehat Foundation (Healthy Mother Earth Foundation) in Ubud. Ms Robin Lim, a midwife and founder of the organization, is an amazing and inspiring woman. The clinic offers free medical services to the local community. This was probably the closest experience to ‘my expectations’ of the trip. It was raw, rural and down to earth midwifery in action. No glamour, just the bare essentials and a whole lot of love to offer these women. We sat with Robin for hours, hearing her stories and asking questions about the centre which has been operating for 20 years and relies on the generosity of many people around the world. It is a place where you can have a traditional Balinese birth with all its beliefs and rituals if you wish to do so. Bali is a very spiritual place and birth is seen as a very spiritual event. This place left an impression on my heart to use my skill for the greater good wherever I choose to practice. This place was one of empowerment and embrace.

Day five, we arrived at the YogaBarn Ubud. This was a great, fun experience to do as a group. We had a private yoga class, presentation about yoga during pregnancy and a tour of the facilities. This was interesting and got me thinking how I could include this in my practice and encourage movement during pregnancy. I often think about the alternative approaches that we can offer women who may not want conventional ideas.

Our last official engagement was on day nine at the Senang Hati Foundation, which assists people living with physical disabilities. In Bali, disabled people are seen as outcasts so this is a really important organization that provides an accepting environment where they can improve the quality of life for these people. We had a presentation, tour and got to talk with the residents. This was not related to midwifery but was still a good experience.

Overall, we had many engagements and cultural activities, which were thought provoking and eye opening. I really enjoyed getting to know the other students and sharing this experience with them. I had been to Bali before so the culture was not a shock for me however I was surprised by how similar midwifery in Bali is to Australia. As a result, this trip was not as challenging as I expected it to be and I feel I did not learn as much as I thought I would. It was truly a fantastic experience and I feel that it will make me a better midwife. I have a new appreciation for the resources and standard of care we do have in Australia and that we are leading by example on a global platform.

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