Perception of childbirth experiences of Japanese women in Bali, Indonesia: a qualitative study.

BACKGROUND: Maternal healthcare services in Indonesia have seen dramatic improvements over the past 25 years and yet there is still room for improvement. The perception, by the women, of the perinatal care provided, is a vital input to further improving these services. This study examines how the perinatal care provided is experienced by Japanese women in Bali, using an interview survey. METHODS: We conducted semi-structured interviews, from August to October 2017, with 14 Japanese women living in Badung Regency and Denpasar City in Bali Province, Indonesia to report their perception of the perinatal care they experienced during their pregnancies. The interview guide included among others, the reasons for choosing specific (perinatal care) health facilities and their satisfaction with their experience of using the antenatal, delivery, and postnatal care services. The data were analysed using the qualitative content analysis method. RESULTS: From the interview data, 12 categories across five themes were extracted. Participants reported experiencing various concerns during their pregnancies such as difficulty in obtaining perinatal care related information. From the beginning of their pregnancies, participants gradually established trusting relationships with midwives, but in many situations, they were disappointed with their childbirth experiences, as they felt that the care provided was not woman-centred. Through their own efforts and with the support of family members and other Japanese residents, many women were able to eventually regard their childbirth experiences as positive. Nevertheless, some women could not overcome their negative impressions even years after childbirth. CONCLUSIONS: Participants desired close attention and encouragement from nurses and midwives. Our results suggest that Japanese women in Bali expected a woman-centred perinatal care and active support from nursing/midwifery staff during their pregnancies and postnatal care.

[The relationship between a mother's internal working model and her tendency to be abusive in her child-raising approach].

OBJECTIVE: The internal working model (IWM) is an outcome of the individual's pattern of development during their childhood and determines attachment styles. Probably the most significant factor that leads to child-abuse is an unstable type of attachment of mothers towards their children. Therefore, the objective of this study was to determine the relationship between a mother's IWM, her tendency to be abusive in her child raising approach and the implications for support to prevent such abuse. METHODS: Use of a self-administered questionnaire for mothers (n = 534) who visited health centers in Ishikawa prefecture for a routine child development check-up. RESULTS: The results showed that mothers with a strongly ambivalent IWM showed an increased tendency towards child abuse when compared with mothers with other types of IWM. Even when these ambivalent IWM mothers were supported, their abusive tendencies did not change. Another aspect that emerged from the study was that mothers with a low tendency for a stable IWM showed more abusive actions towards their child when compared with mothers with other types of IWM. However, these mothers, with support, responded with a reduction in their abusive actions. CONCLUSION: It can therefore be concluded that there is a demonstrable relationship between a mother's IWM and an abusive child-raising approach. It also showed that with mothers having a low tendency for a stable IWM, provision of support can reduce and even prevent child-abuse.