Wednesday, June 9, 2010

THE VILLAGE MIDWIFE - BIDAN KAMPUNG

Who was the 'birth specialist' attending to your dear mom when she delivered you? A gynaecologist or a trained midwife? Or a village midwife (bidan kampung)

In my case, it was home birth.  And the birth attendant was a bidan kampung. All my six other siblings were also delivered by bidan kampung.  Alhamdulillah, none of these natural births which took place in a non-clinical setting, had any complications!

While we celebrate Malaysia's achievements in the delivery of its western-oriented midwifery services (under its maternal and child health care programme),  we might not want to forget the contributions made by our traditional midwives in the rural areas. I feel so greatly indebted to all the village midwives who had deligently assisted my late mother when she gave birth to all my siblings, and me! These birth specialists -just like all the dukun bayi (in Indonesia), the moh tam yae (in Thailand), the matrone (in Cameroon), the daya (in Egypt), the mananabang (in the Philippines) or the partera empirica (in Colombia) -   had undoubtedly played a very significant role in fulfiling the needs of parturient mothers in the villages, as well as their newborn babies, at a time when modern midwifery and child health care services were still so limited and highly inaccesible.

Because of their limited knowledge and lack of training in modern 'obstetrics',  except for those who chose to undertake the short training conducted by the Health Ministry in the late 70s that made them bidan bertauliah or 'licenced bidan', our bidan kampung had since time immemorial, depended on skills and knowledge that they inherited from their predecessors in their practice as midwives.  Such skills and  knowledge, which had been passed down from generation to generation, had over the decades, saved the lives of millions of  newly born babies and their mothers in the rural areas of Malaysia.


Above: Pictures showing (i) the UNICEF box containing kits used by the bidan kampung while attending childbirths, and giving post-natal care, and (ii) a bidan kampung from the village of Sungai Batang, in Rungkup sub-district , Perak state..  This bidan kampung who passed away about 20 years or so ago was referred to by the villagers as 'bidan besar' or 'big' bidan, which means that she was a highly revered midwife. Thank you bidan besar! Hundreds of village babies had safely come into this world, insya Allah, with your assistance.

The Malaysian government introduced The Midwives (Registration) Regulations in 1971. That was seen by many as a means of checking the perpetuation of the bidan kampung institution. Evidently not all the village midwives reacted positively to this regulation and they continued to 'illegally' serve their clients when and where their services were needed.
   
My small research in Rungkup sub-district, Perak, revealed that prior to 1959, pregnant mothers in the area had to depend solely on the services of the bidan kampung. The first midwife clinic was built there in 1963, and more new clinics were established  after that. I was expecting that more if not all deliveries taking place closer to or during 1981 (when the study was conducted) would have been assisted by the government midwives. However, it was found that more than half of the sample mothers still resorted to the services of the traditional bidan for their most recent births (occuring between 1961-1981). More than 70% of these births actually happened between 1971-1981.


An old picture of Klinik Dan Rumah Bidan (Midwife Clinic
cum Quarters) in Rungkup sub-district.

Mothers who chose to enlist the services of the bidan kampung had of course their 'good' reasons for doing so. I will not dwell into this here. Certain social, cultural, psychological as well as situational factors  did contribute to the persistence in the use of the traditional midwifery services in Rungkup. Evidently, some of the reasons for such choice were also associated with the modern midwifery system itself.. 

A lot of things have now changed, including people's attitude towards the modern  midwifery care system introduced by the government. Many, many years have passed. I haven't got the chance to revisit those places where bidan kampung once flourished. But I do know that a few of these 'birth specialists'  who were still quite 'young' when I first met them, are still around. Their role is rather  restricted nowadays. Evidently, as a result of  better accessibility to government midwife clinics, government's ruling pertaining to use of birth attendant during delivery, and change in people's attitude, our traditional 'midwives' today are not anymore enjoying the status they used to occupy before. I wonder whether we could call them bidan or midwives now that their role as birth attendants has actually been fully taken over by the government midwives, stationed in the kampung areas. Clearly the role of the traditional bidan kampung is quite different  now. They are not birth attendants anymore. Today, they function more as traditional masseurs, particularly for puerperium mothers  - perubahan  dari menyambut (kelahiran) kepada mengurut (badan) !


Terima kasih semua. Jasamu tetap dikenang!



Shots of the happy faces of some bidan kampung in Rungkup. 


Reference: Population Reports, Series J, Number 22, May 1980.

19 comments:

Kak Nora said...

Salam TmK,
Thumbs up to all mak bidan. Saya pula disambut oleh 'misi midwife'di sebuah klinik di Jalan Tan Cheng Loke, Melaka. Bidan juga tu, bidan bandar. Oh, ye jangan lupa 'melenggang perut', mak bidan saje kampung yang tau.

Temuk said...

Salam Hjh Nora
All the govt midwives serving the rural areas today are well trained, just like your 'misi midwife'. But some are very young & still single. This was one of the reasons why village mothers didn't quite trust them. Further they knew that the traditional midwives were 'their own people' that they could rely on for lots of other 'services, including, yes, melenggang perut. Have a great weekend!

luahfikiran said...

Salam Temuk,
Allah sahaja yang membalas jasa mereka. LF tak pasti siapa yang menyambut kelahiran LF. Rasanya masa tu bidan kampung. 62 tahun yang lalu !

ckLah said...

10 adik beradik saya dilahirkan di rumah, ditangani seorang bidan kampung yang sama. Antara 10 itu, 5 daripadanya, bapa sendiri yang memotong tali pusatnya.....kerana bidan lambat sampai. Maklumlah, keadaan kampung pedalaman yang masih jauh dari pembangunan masa itu...komunikasi dan perhubungan pun lambat! Alhamdulillah....semua selamat. Antara 10 itu, anak ke 8 paling teruk kelahirannya kerana mak sakit lebih 24 jam. Tapi...hospital jauh. Tunggu saja di rumah hingga lahir. Dan adik saya yang 'payah lahir' itu, antara pekerjaan yang oernah dilakukannya saat dewasa adalah menyambut kelahiran, sebelum dia menjadi doktor pakar (Ketua Jabatan Penyakit Bawaan dan Wabak)di Putrajaya sekarang.

Siti Roffini said...

Salam Temuk,
I find it amusing that it takes a male to penetrate an all-female domain. Nevertheless, a very interesting entry.

Mej (B) Nor Ibrahim Bin Sulaiman said...

Assalamualaikum Cikgu,

I, too, was born through the skills of 'bidan kampung' in Kuala Kangsar. Syukur Alhamdulillah, I'm what I'm now.

Temuk said...

Salam luahfikiran
Mengikut perkiraan saya, besar kemungkinan kelahiran itu disambut oleh bidan kampung. Klinik Bidan kerajaan terdekat masa itu (Spg 4) dibina pada tahun 1963. Tapi mungkin juga kelahiran berlaku di hospital Teluk Anson, tak?

Temuk said...

Salam ckLah
Wow! Itulah kita & kehidupan dulu-dulu! Dan itulah kebesaran ALLAH, tetap mengasihi & membantu kita melalui insan mulia seperti bidan kampung. Saya kagum dengan pencapaian adik ckLah yg menjadi doktor pakar itu. Kalau dia jadi pakar sakitpuan, lagilah menyeronokkan, kan? Saya pasti adikberadik lain yg lahir di tangan bidan kg dulu juga berjaya. Insya Allah. Saya pernah membaca tentang adanya bidan kampung lelaki di kalangan masyarakat kita dulu (rasanya di Terengganu). Yg ayahanda ckLah lakukan itu amat menakjub & membanggakan.

Temuk said...

Salam Pn. Siti Roffini
Thank you for your interest in my recent entry. As a man, there were several constraints that I had to face in my investigation of the traditional birthing and midwifery practices. I had to depend a lot on my female research assistants. Now, of course, I don't do that kind of research anymore. But I still find materials on childbirth practices among less developed communities amusing.

Temuk said...

Wa'alaikumussalam Mej Nor Ibrahim
Syukur! Memang ramai bidan kg ni suatu masa dulu. Dianggarkan pada awal 80an ada seramai 3,000 bidan kg di Semenanjung Malaysia. Pasti bilangannya lebih tinggi jika dimasukkan Sabah & Sarawak. Mereka memang berjasa besar. Agaknya di kawasan pendalam Sabah & Sarawak sekarang, masih ada mereka ini & masih berfungsi menyambut kelahiran bayi.

ahmad humairi said...

salam,

Kat sini rupanya dia nyorok!
Menyorok bersama-sama mak bidan tuh.

Masih ada beberapa orang lagi Mak Bidan yang sedia memberikan khidmat emergency di kampung saya. Jiran terdekat paling beruntung.

Sekarang mak-mak bidan diperlukan selepas kelahiran untuk berurut. Mereka pakar yang diperlukan ibu-ibu untuk mendapatkan zuriat atau menambah bilangan ahli keluarga (Kak Nora tak boleh joinla kot?)

Ceria Selalu..

H.N.Liew said...

Dear Temuk,
I enjoyed reading your blog postings.
Many people opted to have their babies borned in the clinics or hospitals. But I feel, babies should be borned at homes and handled by a skilled bidan. The only problem is the homes should be near the hospital in case of emergency.
Babies born at home enjoyed natural birth. Without injection and drugs, the babies develope natural immunity. Most important the babies must be breastfed.
Visit blog: savingeverydrop.blogspot.com for more information on breastfeeding and natural childbirth.
For curing diseases, visit blog: detox4cure.blogspot.com

Temuk said...

Salam Cikgu Humairi
Mujur jumpa! Kalau maksud cikgu, bidan2 tu masih menyambut kelahiran (sekalipun utk kes kecemasan), maknanya memanglah perkhidmatan mereka sebagai bidan masih 'on'. Memang ramai bekas bidan kg jadi tukang urut wanita. Perkhidmatan SPA moden hari ni patut gunakan ex-bidan kg jadi pengurut.

Temuk said...

Hi H.N.Liew
Thanks for dropping by. It is interesting to note that some groups of women in the highly developed countries prefer to deliver their babies the natural way, within the home setting, and be surrounded by family members. When societies like ours become 'medicalized', as sociologists use to say, we tend to look at childbirth as a highly risky process that necessitates the intervention of skilled personel, like trained midwives or gynaecologists, and a proper clinical setting. So, we now view giving birth the traditional and natural way incorrect & unacceptable. Thanks for introducing me to those blogs on natural childbirth, breastfeeding and alternative methods of curing. I will certainly visit them later. Have a nice day!

ahmad humairi said...

salam kembali Abang Temuk,


(Respon saya pada komen Abang Temuk pada entri Si Kembang Naga)

Saya dah cuba klik ke entri terbaru tu (Daddy Zuki). Pertama saya klik pada Blog Nukilan - paparan Alahai Kenanga terpapar. Saya cuba skrol ke bawah, kot-kot dia menyorok di mana-mana macam entri Bidan Kampung tu. Tak jumpa. Saya klik pula pada isi kandungan. "Blogger does not exist" terpapar. Ingat nak mail Abang Temuk...tertangguh kerana aktiviti lain. Tak mengapalah, saya setia menunggu apa-apa sahaja berita dari Abang Temuk.

Saya rasa Entri Mak Bidan tu di savekan dalam draf dan bila dipublishkan dia diterbitkan mengikut tarikh dalam draf, wallahualam.

Buatkan Shout-box di laman Abg Temuk...senang nak chat...

Temuk said...

Salam Cikgu Humairi
Terima kasih. Respon saya dlm ruang komen Bunga Naga cikgu.

shoshana said...

I would like to contact the author of this blog. Are the midwives still practising?

Temuk said...

SHOSHANA
It was just by chance that I came back to this old entry and noticed I that you have dropped a line here. Thank you. For your information, there are no more traditional birth attendants in Malaysia now. The last few that might still be around do not attend to deliveries anymore. They might still help the womenfolks by giving them "massage" services, locally termed as "urut". Our rural midwifery services have now been modernized and expanded tremendously.

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