Our recent trip to Bali as part of the Midwifery in Indonesia has left me reflecting on a concept suggested by Robin Lim of the Bumi Sehat Birthing Centre, that birth revolves around three aspects: spiritual, nature and science. And indeed the more that this concept is thought about the more it can be seen in everyday life of Bali and the Hindu culture, as well as our own.
The spiritual aspect of birth seems to revolve around the act and rituals involved in the process itself. For instance, at Bumi Sehat Birthing Centre, the idea of ‘Gentle Birth’ is practiced, respect is shown for the new individual and the change in roles of the soon to be mother by keeping interventions to a minimum, lights dimmed, and noises soft. When the newborn arrives, all those who witnessed the birth sing a spiritual or religious song from the culture that the newborn will be raised in, usually Hindu, Islam or Christianity.
This spiritual aspect seems to resonate highly with the work of midwives, even in Australia, as we act to provide the rituals, routines and practices that women associate with birth. In the broader Balinese society, spirituality plays a large part of everyday life, as almost all actions and objects have a sacred meaning and associated ritual, making life in general a spiritual journey. To reflect on my own practice in line with spirituality, I feel that more emphasis should be put on the woman’s wishes during labour and birth. As midwives, it is our opportunity to create the spiritual space and experience, which many women crave in this life event.
If the spiritual aspect of birth can be viewed as a midwife’s domain, than nature is most definitely that of the woman. This trip has taught me many things on what is often included in a birthing room, compared to the necessities in a birthing room. In comparison to many of the hospitals visited on this trip, the two birthing centres visited concentrated and respected the instincts of the mothers. Their practice seemed to revolve around allowing nature to take it’s course, and monitoring in order to provide interventions only when necessary. This was in stark contrast to both the public and private hospitals visited, whose focus involved care based on technology, distancing themselves from the idea of ‘normal birth’.
The final aspect of birth suggested in this model is science, a domain traditionally held by doctors, but with the rise in technology, has become more available to both midwives and women. This was particularly evident in the presentations by the hospitals visited in that questions were usually half answered by Obstetricians and other doctors, and then answered in full by midwives, often accompanied by evidence in the literature.
It became clear early on that women in Indonesia have numerous choices when it comes to birth, whether that is hospitals or birthing centres, similar to what is found in Australia. And likewise, women are often uninformed of the choices available in both countries. This educational experience has made me re-examine my views on hospital-care and come to the conclusion that as midwives, as long as we allow spirituality, nature and science to shine through in our practice, it does not matter what establishment we provide care in. Furthermore, experiencing many cultural activities as well as those related to midwifery has shown me that these three aspects can be related to everyday life beyond the world of maternity.
10 photos of the trip
Sexual health education in the market place
Midwife holding pot in which the placenta is placed before being buried under the family home
Third year midwifery students at Kartini School performing a dance based on the international understanding of midwifery, in traditional Balinese style
Symbol of Bumi Sehat Birthing Centre
Robin Lim discussing international midwifery issues with the group
Small temple next to Tanah Lot
Tanah Lot temple
Preschoolers associated with the Bali Children’s Project
School children associated with the Bali Children’s Project
Drum circle with Senang Hati Foundation