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This research examined the extent to which women weigh political, religious, and ethnic dimensions of health care throughout their pregnancies in rural Sumbawa, Indonesia. As a country, Indonesia is undergoing rapid economic growth, is attempting ethnic unification, rapid modernization, and entrance into the global economic community. Indonesian government programs have addressed high maternal mortality rates by introducing biomedical health care to settings that already have traditional health care systems. For a variety of reasons, women in Indonesia often do not use these programs to the extent expected. The government programs identify women’s roles in this modernization process as crucial: women are the locus of both biological and cultural reproduction as well as social change. While the goal of Indonesian nationalist policy is to ideologically and physically give birth to a new generation of Indonesians, the many ethnic groups are simultaneously attempting to reproduce local traditions, improve their life chances and most recently are drawing more distinct lines between themselves and other ethnicities.
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I conducted this research over seventeen months in an ethnically and religiously diverse village on the island of Sumbawa, in the province of Nusa Tenggara Barat. My research entailed doing participant observation, surveys and interviews with all those associated with pregnancy and delivery in the village including the pregnant women and the midwives (both shaman and biomedically trained) in the form of an apprenticeship. This entailed learning about the local understandings of the physiology and cosmology associated with reproduction and care of families who are reproductively active as well as how a biomedical obstetrics is understood and practiced in this rural region.
My research shows that there is often a careful consideration of alliances that factor into perceptions about how to best care for a pregnancy. Thus, elements of
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religion, culture, politics, social structure, and ethnicity intertwine to develop a local logic of how best to treat a pregnancy. The data from my research also show that through the process of reproduction the people in rural communities are uniquely confronted with their position vis-à-vis the industrialized world outside of both their regional and national boundaries. This contact with the “modern” world comes through maternal health programs and the technology that is introduced to care for pregnancy. The dialogue that existed in the community about the various pregnancy and delivery health care options, is very interesting and reveals robust local conflicts about religious, ethnic, and political identity that often exists within families and the larger community.
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