Rural Javanese midwives: Accommodating and resisting biomedicine

This dissertation explores how "modern" obstetrical principles are combined with traditional midwifery practices, producing hybrid forms of women's reproductive health care in rural Java. The Indonesian government promotes the adoption of Western biomedical approaches to delivery, infant care, and family planning. Indonesian village-based midwives adopt, adapt, and resist various aspects of national medical policy and training. Through these providers, actual health care practices reinforce but also diverge from national policies, producing a plethora of contrasting practices at the local level.; This range of local-level practices is ethnographically illustrated through accounts of particular providers. At the center of the dissertation stands Mrs. R, an accomplished nurse-midwife (bidan), who implicitly combines ethnomedical and biomedical practices and beliefs in her successful rural practice. This allows the arm of the national government to reach into the countryside at the same time it enables the perpetuation of tradition through the numerous ways that Mrs. R accommodates tradition in her practice. Thus does she indigenize nation biomedicine and the global flows of knowledge and technology that inform and enable it.; Nurse-midwives have been exposed to Western scientific knowledge through their education and in turn train traditional midwives, the dukun bayi. The dukun bayi has less formal education than the bidan and belongs to a lower class. However, the dukun bayi is also viewed by her clients as an expert in the ethnomedical practices that surround reproduction. The practices of the dukun bayi , as they contrast with but also complement those of the bidan, are closely observed, as is the effective collaboration of these two agents of change in the area of women's reproductive health.; Despite the various accommodations and hybridizations, biomedical technology, practices, and ideology also conflict with indigenous practices; and providers and patient alike sometimes resist the incursions of the state in this domain. The penultimate chapter shows how family planning is both an empowering instrument and problematic curtailment of women's own fertility.; Today's rural Javanese practices in the area of women's reproductive health are varied and contested, enabling but also limiting government control over women's bodies and their fertility.