•  
  •  
 

Antropologi Indonesia

Abstract

This article reads lotus birth—the practice of leaving the umbilical cord intact until it separates naturally—as an ethnographic event that illuminates how biomedical power operates in contemporary Indonesian midwifery. Drawing on reflexive ethnography of two births attended by the author as a doula—one at a maternity clinic in South Tangerang (2020) and one at a home birth in South Jakarta (2022)—the article argues that the phrase "as long as mother and baby are safe" does not function as a neutral condition. Rather, it operates as Gramscian hegemonic common sense: appearing self-evident and beyond question, while simultaneously determining which signs count as significant, who holds authority to read the body, and what responsibilities must be met for an unconventional choice to be deemed legitimate. Lotus birth does not oppose biomedical safety language; it moves through it, via negotiations conducted through clinical examination, conversation, observation, and the redistribution of care responsibilities to the family. This article contributes to medical anthropology by demonstrating that "safety" in birth practice is not merely a clinical indicator but a language that organizes relations, regulates epistemic authority, reframes the status of the placenta, and transfers responsibility for safety from clinical space into the domestic sphere.

Bahasa Abstract

Artikel ini membaca praktik lotus birth—membiarkan tali pusat tetap terhubung hingga terlepas secara alami—sebagai peristiwa etnografis yang membuka cara kerja kuasa biomedis dalam kebidanan kontemporer di Indonesia. Berdasarkan pendekatan etnografi reflektif atas dua kasus persalinan yang penulis dampingi sebagai doula—satu di klinik bersalin di Tangerang Selatan (2020) dan satu di rumah di Jakarta Selatan (2022)—artikel ini berargumen bahwa frasa "selama ibu dan bayi aman" tidak bekerja sebagai syarat netral. Ia bekerja sebagai akal sehat hegemonik dalam pengertian Gramscian: terasa wajar dan tidak perlu dipertanyakan, namun secara bersamaan menentukan tanda apa yang harus diperhatikan, siapa yang paling berwenang membaca tubuh, dan tanggung jawab apa yang harus dipenuhi agar pilihan yang tidak lazim itu dianggap sah. Lotus birth tidak menolak bahasa keselamatan biomedis, melainkan melewatinya melalui negosiasi yang berlangsung dalam pemeriksaan klinis, percakapan, pengamatan, dan distribusi tanggung jawab perawatan ke tangan keluarga. Artikel ini berkontribusi pada antropologi medis dengan menunjukkan bahwa "aman" dalam praktik persalinan bukan sekadar indikator klinis, melainkan bahasa yang menata relasi, mengatur otoritas pengetahuan, mengubah status plasenta, dan memindahkan tanggung jawab keselamatan dari ruang klinik ke ruang domestik.

References

American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice 2020 Delayed Umbilical Cord Clamping After Birth: ACOG Committee Opinion, Number 814. Obstetrics & Gynecology 136(6):e100–e106. https://doi.org/10.1097/AOG.0000000000004167

Bohren, Meghan A., George J. Hofmeyr, Carol Sakala, Rie K. Fukuzawa, and Anna Cuthbert 2017 Continuous Support for Women during Childbirth. Cochrane Database of Systematic Reviews 7:CD003766. https://doi.org/10.1002/14651858.CD003766.pub6

Bonsignore, Alessandro, Francesca Buffelli, Rosagemma Ciliberti, Francesco Ventura, Andrea Molinelli, and Ezio Fulcheri 2019 Medico-Legal Considerations on “Lotus Birth” in the Italian Legislative Framework. Italian Journal of Pediatrics 45(1):39. https://doi.org/10.1186/s13052-019-0632-z

Browner, C. H., and Nancy Press 1996 The Production of Authoritative Knowledge in American Prenatal Care. Medical Anthropology Quarterly 10(2):141–156. https://doi.org/10.1525/maq.1996.10.2.02a00030

Candea, Matei, ed. 2018 Schools and Styles of Anthropological Theory. London: Routledge.  https://doi.org/10.4324/9781315388267

Chaparro, Camila M., and Chessa K. Lutter 2009 Beyond Survival: Integrated Delivery Care Practices for Long-term Maternal and Infant Nutrition, Health and Development. Washington, DC: Pan American Health Organization/WHO. https://www.paho.org/sites/default/files/BeyondSurvival.pdf

Cheyney, Melissa J. 2008 Homebirth as Systems-Challenging Praxis: Knowledge, Power, and Intimacy in the Birthplace. Qualitative Health Research 18(2):254–267. https://doi.org/10.1177/1049732307312393

Coates, Dominiek, and Christine Catling 2021 The Use of Ethnography in Maternity Care. Global Qualitative Nursing Research 8:23333936211028187. https://doi.org/10.1177/23333936211028187

Crehan, Kate 2011 Gramsci’s Concept of Common Sense: A Useful Concept for Anthropologists? Journal of Modern Italian Studies 16(2):273–287. https://doi.org/10.1080/1354571X.2011.542987

Daemers, Darie O. A., Evelien B. M. van Limbeek, Hennie A. A. Wijnen, Marianne J. Nieuwenhuijze, and Raymond G. de Vries 2017 Factors Influencing the Clinical Decision-Making of Midwives: A Qualitative Study. BMC Pregnancy and Childbirth 17:345. https://doi.org/10.1186/s12884-017-1511-5

Downe, Soo, Kenneth Finlayson, Olufemi T. Oladapo, Mercedes Bonet, and A. Metin Gülmezoglu 2018 What Matters to Women during Childbirth: A Systematic Qualitative Review. PLOS ONE 13(4):e0194906. https://doi.org/10.1371/journal.pone.0194906

Forster, Della A., and Helen L. McLachlan 2007 Breastfeeding Initiation and Birth Setting Practices: A Review of the Literature. Journal of Midwifery and Women’s Health 52(3): 273–280. https://doi.org/10.1016/j.jmwh.2006.12.016

Gramsci, Antonio 1971 Selections from the Prison Notebooks. Edited and translated by Quintin Hoare and Geoffrey Nowell Smith. London: Lawrence & Wishart.

Healy, Sandra, Eileen Humphreys, and Catriona Kennedy 2016 Midwives’ and Obstetricians’ Perceptions of Risk and Its Impact on Clinical Practice and Decision-Making in Labour: An Integrative Review. Women and Birth 29(2):107–116. https://doi.org/10.1016/j.wombi.2015.08.010

Jordan, Brigitte 1997 Authoritative Knowledge and Its Construction. In Childbirth and Authoritative Knowledge: Cross-Cultural Perspectives. Robbie E. Davis-Floyd and Carolyn F. Sargent, eds. Pp. 55–79. Berkeley: University of California Press.

Kelly, Paula, Nicole Snow, Maggie Quance, and Caroline Porr 2023 Elucidating the Ruling Relations of Nurses’ Work in Labor and Delivery: An Institutional Ethnography. Global Qualitative Nursing Research 10:23333936231170824. https://doi.org/10.1177/23333936231170824

Kusumawati, Nila, Erlinawati Erlinawati, Yenny Safitri, Muhammad Nurman, and Fitry Erlin 2023 Exploring Women’s Reasons for Choosing Home Birth with the Help of Their Untrained Family Members: A Qualitative Research. International Journal of Community Based Nursing and Midwifery 11(2):72–84. https://doi.org/10.30476/IJCBNM.2023.97491.2186

Laidlaw, James 2018 The Anthropological Lives of Michel Foucault. In Schools and Styles of Anthropological Theory. Matei Candea, ed. Pp. 173–184. London: Routledge. https://doi.org/10.4324/9781315388267

Lim, Robin 2010 Placenta: The Forgotten Chakra. Ubud, Bali: Half Angel Press.

Monroe, Kimberly K., Alexandra Rubin, Kerry P. Mychaliska, Maria Skoczylas, and Heather L. Burrows 2019 Lotus Birth: A Case Series Report on Umbilical Nonseverance. Clinical Pediatrics 58(1):88–94. https://doi.org/10.1177/0009922818806843

Newnham, Elizabeth C., Jan I. Pincombe, and Lois V. McKellar 2016 Critical Medical Anthropology in Midwifery Research: A Framework for Ethnographic Analysis. Global Qualitative Nursing Research 3:2333393616675029. https://doi.org/10.1177/2333393616675029

Peterwerth, Nina H., Margareta Halek, and Rainhild Schäfers 2022  Intrapartum Risk Perception—A Qualitative Exploration of Factors Affecting the Risk Perception of Midwives and Obstetricians in the Clinical Setting. Midwifery 106: 103234.  https://doi.org/10.1016/j.midw.2021.103234

Rudiyanti, Novita, and Budi Utomo 2024 Challenges of Health Workers in Primary Health Facilities in Implementing Obstetric Emergency Referrals to Save Women from Death in Indonesia: A Qualitative Study. Belitung Nursing Journal 10(6):644–653. https://doi.org/10.33546/bnj.3525

Scamell, Mandie, and Andy Alaszewski 2012  Fateful Moments and the Categorisation of Risk: Midwifery Practice and the Ever-Narrowing Window of Normality during Childbirth. Health, Risk and Society 14(2): 207–221. https://doi.org/10.1080/13698575.2012.661041

Simon, Leslie V., Muhammad F. Hashmi, and Bradley N. Bragg. 2023. "APGAR Score." StatPearls. Treasure Island, FL: StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470569/

Steer-Massaro, Courtney 2020 Neonatal Omphalitis After Lotus Birth. Journal of Midwifery & Women’s Health 65(2):271–275. https://doi.org/10.1111/jmwh.13062

Syairaji, M., Detty Siti Nurdiati, Bayu Satria Wiratama, Zita D. Prüst, Kitty W. M. Bloemenkamp, and Kim J. C. Verschueren 2024 Trends and Causes of Maternal Mortality in Indonesia: A Systematic Review. BMC Pregnancy and Childbirth 24(1):515. https://doi.org/10.1186/s12884-024-06687-6

Titaley, Christiana R., Cynthia L. Hunter, Michael J. Dibley, and Peter Heywood 2010 Why Do Some Women Still Prefer Traditional Birth Attendants and Home Delivery?: A Qualitative Study on Delivery Care Services in West Java Province, Indonesia. BMC Pregnancy and Childbirth 10:43. https://doi.org/10.1186/1471-2393-10-43

Viisainen, Kirsi 2001 Negotiating Control and Meaning: Home Birth as a Self-Constructed Choice in Finland. Social Science & Medicine 52(7):1109–1121. https://doi.org/10.1016/S0277-9536(00)00206-9

World Health Organization 2018 WHO Recommendations: Intrapartum Care for a Positive Childbirth Experience. Geneva: World Health Organization.

World Health Organization 2023 Optimal Timing of Cord Clamping for the Prevention of Iron Deficiency Anaemia in Infants. Geneva: World Health Organization.

WHO, UNICEF, UNFPA, World Bank Group, and UNDESA/Population Division 2023 Trends in Maternal Mortality 2000 to 2020: Estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division. Geneva: World Health Organization.

Download

Share

COinS