Traditional midwives play a positive role in bringing healthy Indonesian children into the world. But an unknown number secretly help women to end unwanted pregnancies, by mixing poisonous concoctions or by 'abdominal massages' that can cause their patients to bleed to death.
Every year, midwife Ibu Eka delivers 10 to 15 babies in a densely populated community in East Jakarta. Like many Indonesians, Ibu Eka has little sympathy for women who get pregnant from premarital sex, which she calls 'sinful'. She has even less sympathy for those seeking abortions. 'Many women have asked me to get rid of babies,' she says. 'I always refuse. I deliver babies, I don't kill them.'
The job of midwife is often inherited - Ibu Eka's mother and grandmother both did it - and includes mystical duties, such as offering prayers over a newborn baby's fontanel or arranging for the ritual burial of the placenta. When Ibu Eka started in the 1960s, she cut the umbilical cord with a bamboo knife and used turmeric as an antiseptic. Local government clinics now train and certify them as official health workers.
Not before time. There is a huge gulf in maternal welfare standards between developed and developing countries. A woman in Canada has a one in 8,700 chance of dying as a result of pregnancy. In the Philippines, those odds are one in 75. Nearly all maternal deaths now occur in poor nations such as Laos - where 530 women die for every 100,000 live births - or Indonesia, where 370 women die for every 100,000 live births.
Like many Indonesian politicians and nearly all its religious leaders, Ibu Eka strongly opposes the decriminalisation of abortion. 'If you make it legal,' she says, 'then everyone will do it.'
