Dr. Mohammad Baharuddin, SpOG, MARS

Respectful Care at Birth

Definition Is a unique approach which has been implemented whose

target is to make childbirth a positive and satisfying experience for both women and their famiy as a whole

Considering women’s values, beliefs, feelings, and respecting their dignity and autonomy during birthing process

Reducing over medicalized childbirth, empowering women and the use of evidence based maternity practice are strategies that promote humanized birth

References : Behruzi et all BMC Pregnancy and Childbirth 2010 10:25

Budi Kemuliaan Association

Is a Non-profit civil society organization

established in 1912

by

Indonesians & Dutch Pioneers

Inspired by

Princes Kartini’s Book

(Indonesian Hero & Philosopher)

“BRIGHTNESS AFTER DARK”

Religion

Letter to Eddie A – August 15, 1902. How happy I am looking

for the best in and of every aspect. The Light of God is in

every person, in every thing, even in worst thing. Truthfulness

must get soaked in the inner spirit of people, making it

transparent for all to see it as an obligation. This very

transparence, makes life so beautiful, both for others and for

ourselves

Idealism

…in our imagination which is so clear and bright ;

We shall work hard for the sake of our people, educate and

enhance their characters, so as to make it possible for them be

a better nation

Kartini’s Letter #1

Kartini’s Letter #2 Women , Letter to Mrs. Abendanon, January 1901

embodiment of my imagination about women, which is preferably a blend of noble conduct and manner as well as highly intellectual character accompanied by eternal womanhood nature Because I am very sure, that women may give big influence to the society. The apple of my eye is no more than becoming a teacher. I want very much to educate children and to build their characters, to make their young mind smart, to develop them into future women

Kartini’s Letter #3

Education , A letter to Nellie V. Kol – August 1901

For me, educating is developing characters and intellectual. The teachers’ task does not cease in developing senses only, but also in compulsorily maintaining character development. Teachers shall have moral obligation though no legal obligation obliges. It is decency to bear in mind that intellectual development alone shall not a guarantee of its ethics.

Budi Kemuliaan Maternity and

Children Hospital Established

in 1917

In an area of

10.809 square meter

Budi Kemuliaan Health Institution

provides

Reproductive Health Services (Budi Kemuliaan

Maternity and Children Hospital)

Education (Midwifery Academy )

Training and Research

Budi Kemuliaan Association The members of Budi kemuliaan Association are not

entitled for receiving the “profit” (dividend).

The said “profit” shall be returned in the form of Health

Institution improvement and employees welfare to be A

Model

As a result, Budi Kemuliaan Health Institution is the

public asset, which is implemented by the public and

benefited by the public.

Mission

to ensure growth and development of better future

generation through the best and affordable health services

as well as continuing community based implementation in

health services, education,training and research

Vision

to become a credible health

institution which provide the best

and affordable health services for all

strata of the society, to build a better

generation .

Budi Kemuliaan Objective of Business

2008-2013

Health institution with an organization structure and management system which capable to respond to an integral service-education-training-research.

Health institution which has already implemented an optimal essential Health Reproduction service.

Health institution which capable to identify and establish strategies and produce valuable researches in the society as well as to initiate research cooperation.

Health institution which capable to educate and train human resources to become ‘agent of change’

Political Charge

Technical Charge

Sustainable ---– cultural change

Enterprise-

inspiration

SME Marketing

Strategy

Tactic

Value

Customer Value

People Value

Shareholder Value

Outlook

Architecture

Scorecar

d

Culture

Institution

Segmentation

Targeting

Positioning

Differentiation

Marketing

Mix

Selling

Brand

Service

Process

Change Competitor/Custome

r Company

The Six Pillars of Character

Delivery Room

As Model for Care Budi Kemuliaan Hospital:

Provide with assumption that the service be given to

everyone who have respect and dignity

Deposit-free on admission

Selected cases for free treatment

Choices of services according to the level of providers

Implementation of standard care

Results Maternal death

Near-miss case audit

Medical Audit

CPD /Training

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

6,2

16

6,5

61

7,3

35

6,6

72

6,5

44

6,1

00

6,1

51

6,6

33

7,6

26

7,9

77

7,7

73

7,9

48

Number of Delivery

CFR 2011

DEATH CASE RATE %

CASE FATALITY RATE OF PE/E

5 467 0.01 1.07

CASE FATALITY RATE OF PPH

1 26 0.04 3.85

Budi Kemuliaan Characteristics of the setting regarding to

childbirth practice

NO CHARACTERISTIC

1. Average childbirth per year 7.948

Referral Cases to hospital 51%

2. Medical Interventions :

C-section rate 27%

Epidural analgesia -

Episiotomy with indication for first pregnancy 7%

Continues Electronic Fetal Monitoring +

Routine IV line in normal pregnancy -

3. Physical environment :

Joining room for family +

Private post partum room +

Shared postpartum room +

Individual room for all labour +

Budi Kemuliaan Characteristics of the

setting regarding to childbirth practice

NO CHARACTERISTIC

4. Main care providers :

Nurse-Midwife +

Obstetricians & Gynaecologists +

General Practitioners +

5. Continuity of care :

Care is provided by the same care provider during

prenatal

occationally

6. Natural methods of relieving pain :

Emotional support by companion +

Emotional support by midwife companion +

Changing position +

Breathing techniques +

Budi Kemuliaan Characteristics of the

setting regarding to childbirth practice

NO CHARACTERISTIC

7. Rules/Regulation :

Eating during labour +

Conditional companion during labour and delivery +

Companion C-section Rare

Having kid’s companion Rare

Companion in post partum period +

Staying baby in mother’s room in first 24 h after

delivery

+

Breast feeding within first hours of life +

Rooming-in +

Average duration of hospitalization after C-section 2-3 days

Average of hospitalization after normal vaginal

delivery

2 days

BK Exit questionaire 2011

78.3%

86.6%

86.4%

80.8% 80.1%

83.6%

82.0%

86.8%

85.5%

81.1%

84.3%

84.4%

Friendly Good attitude

Humanic Clues Can Convey

Respect – or Disrespect

Respectful treatment of the customer is

fundamental to delivering a quality services ;

no customer wants to feel disrespected

Disrespectful service is inherently

Poor service