The Effect of Malay Health Care on Postpartum Mothers in Pontianak

The Malay ethnic group occupies the first position in the city of Pontianak. The customs are also attached to the majority of the people who are there and are carried out from generation to generation and are believed to be beneficial for them. The Malays believe that during the puerperium a mother's health must be very concerned, because the complications that occur during the puerperium are very dangerous for the mother and can cause death. This study aims to analyze postpartum maternal health care for Malays in Pontianak. This study uses a qualitative descriptive method through a case study approach. This research was conducted in the District of East Pontianak, in the ethnic Malay community in the Malay village. Data was collected through observation, and interviews. The results of the study showed that there were health treatments during the puerperium carried out by Malays, namely bejah, drinking herbs and decoctions, using poultice, param and pilis. There are many benefits of health care during the puerperium in Malay people, but there are also side effects and disadvantages of this health care.


Introduction
The Malay ethnic group occupies the first position in the city of Pontianak. The customs are also attached to the majority of the people who are there and are carried out from generation to generation and are believed to be beneficial for them. The ancestors and ancestors have inherited various kinds of traditional wisdom which is a cultural wealth that grows and develops in society, and is empirically able to maintain the noble values of culture (Rafiek, 2012;Chandra et al., 2018). One of the customs that is still carried out by the Malays in Pontianak is health care for mothers after giving birth or during the postpartum period.
Postpartum maternal health care for Malays in Pontianak is considered as mandatory care that they must do after giving birth (Darwis & Hikmawati, 2017). Even though there are now doctors, midwives and other health workers, they still carry out various taboos and recommendations from their customs (Aditama, 2014). This is done side by side, they still consult with health workers, but also continue to follow the tradition according to the customs of the Malay people in Pontianak in maintaining health during the postpartum period (Triana et al., 2015).
The Malays believe that during the puerperium a mother's health must be very concerned, because the complications that occur during the puerperium are very dangerous for the mother and can cause death (Widowati & Hasanah, 2015). Various efforts were made to care for maternal health during the puerperium by Malays in Pontianak. The treatment starts from giving decoction of medicinal plants, taboos that should not be eaten, activities that should In addition to the benefits, there are also side effects for postpartum mothers who carry out health care with Malay customs. Not all treatments can be accepted by postpartum mothers. There are some postpartum mothers who say it is not suitable, uncomfortable, or even worsens their condition during the postpartum period.

Methods
This study uses a qualitative descriptive research method, and uses a case study approach to reveal postpartum maternal health care for Malays in Pontianak. The researcher is the main instrument in this research. This research was conducted in the District of East Pontianak, in the ethnic Malay community in the Malay village.
The technique of determining the informants used snowball sampling. In this process the researcher asked for recommendations of people who could be interviewed next from key informants. This technique is used in order to obtain informants who have knowledge and experience on the research topic.
Informants who are used as subjects in the study are classified into two groups, first key informants, namely people who clearly know the conditions of the research area and are able to show who can provide information about the problem under study. Where those who act as key informants are community leaders who are respected and play an important role in the community and people who help the process of postpartum maternal health care for Malays (shamans or parents who care for postpartum mothers with Malay customs).

Second, informants are mothers who have done postpartum care for Malays in Pontianak.
People who know about the problem under study, namely the indigenous Malay community, who provide in-depth information about experiences, opinions, or beliefs, knowledge about values, attitudes and responses in post partum maternal care for Malays that has been carried out so far.
Primary data is the main data obtained from the results of the study. In this study, primary data were obtained directly from the results of in-depth interviews with selected informants, namely local community leaders, postpartum mothers, and traditional birth attendants/parents who had been previously determined as sources of information, in the form of in-depth interviews about health care. postpartum mothers in Malays in Pontianak.
Data collection techniques using observation techniques (observation) and in-depth interviews (in-depth interviews). Full observations are made as long as the event exists and can be observed to be observed, but if the event does not exist, incomplete observations will be carried out. Incomplete observations were carried out using secondary data from informants. In indepth interviews, researchers determine the right time to carry out research, followed by introductions to informants then asking questions from the core of the problem to informants. The researcher then asks questions from the core of the problem to the informant who is considered to have a lot of knowledge regarding the study problem, and is able to provide the information well.
Data analysis in this study uses Miles and Huberman interactive model data analysis techniques, namely data reduction, data presentation and conclusions/verification.

Decoction and Herbal Medicine
There are 3 types of decoctions and herbs that the mother must drink for 40 days after giving birth. The three types of decoctions and herbs are laxative, wind, and veins. The first decoction and herbal medicine given to postpartum mothers were the decoction and herbal medicine 'Lightening'. This decoction and herbs are given in the hope that they will dissolve the frozen and dirty blood that is still left in the mother's womb after giving birth (Parekh et al., 2018;Tonei, 2019). By drinking this decoction and herbs, local people believe it will cleanse the uterus and speed up the healing process for the mother. Decoction and herbal laxatives are drunk for approximately 15 days after giving birth.

Figure 2. Decoctions and herbs
giving birth the stomach that had enlarged back to normal and not sagging. Poultices are also believed to restore the size of the uterus to return to normal.

Param
The purpose of using param is to maintain body warmth, improve blood circulation so as to prevent swelling in the mother's body and breasts, also can smooth the skin. Param is usually used for 40 days postpartum. Param is made from rice which is added with spices such as galangal, liya (ginger), coriander, etc. then crushed and applied to the body. The face, body and stomach of the spice ingredients are slightly different, depending on the level of the param heat.

Pilis
The purpose of the pilis is installed so that the mother's eyes after giving birth do not become infected, red, itchy, swollen which is called stinging and watering which is called menaes in Malay. If left unchecked, it can cause blindness, because when you press there are broken veins in the eye area.

Spawn
Postpartum care with surgery is believed to have good benefits for postpartum mothers. However, it has limitations in its implementation. One of them cannot be done alone by the postpartum mother, so it requires help from people who know the procedures for its implementation. According to traditional birth attendants, bejah is best done shortly after delivery.
For mothers who give birth in hospitals or health facilities, it is considered impractical and can be dangerous for postpartum mothers. So that postpartum mothers who do bejah are not too many, and choose to skip this ritual.

Decoction and Herbal Medicine
Decoction and herbs are also believed to have good benefits for the body. Postpartum mothers in Pontianak rarely skip drinking decoction and herbs after giving birth. However, according to mothers who have consumed decoction and herbs for childbirth, in the long term it can cause constipation. Of some postpartum mothers who experience constipation, the condition is aggravated by the perineum that is torn during delivery, causing the mother after giving birth to be afraid to push. Squatting is also a taboo after giving birth, thus increasing the mother's difficulty during defecation. This can be prevented by increasing water intake. Postpartum mothers who consume herbs and decoctions are required to drink more water, so that the bowel movements are not too hard, and consume vegetables and fruit. If constipation occurs, postpartum mothers are advised to increase their water intake and use laxatives if needed.

Poultice
Poultices are believed to make the mother's stomach after giving birth become slim again. However, some mothers said they felt uncomfortable using the poultice, because it was itchy, and the dust from the poultice polluted the bed and the area occupied by the postpartum mother.

Param
Some postpartum mothers say that after using param their body feels warm. However, some mothers also said that using param if done alone requires more time, and param used alone cannot be thorough throughout the body. For postpartum mothers who spend their own postpartum period, or do not have anyone to help put on param, it is considered a hassle to do.

Pilis
Pilis is considered to prevent swelling, infection, or itching of the eyes after childbirth. There are no significant complaints when using pilis. The use of pilis is more or less the same as a poultice, it is considered to contaminate the bed and the area in contact with pilis. So that is the reason postpartum mothers do not want to use pilis.

Conclusion
The Malays in Pontianak highly respect their customs and traditions, especially in health care during the postpartum period. There is routine postpartum health care that must be done. Postpartum health care that is commonly carried out by Malays is bejah, drinking herbs and decoctions, taking pals, using param and pilis. There are many benefits of health care, but there are also side effects and disadvantages of health care in the postpartum period. Such as surgery, can not be done alone, requires an expert to help the postpartum mother do the surgery. Herbs and decoctions consumed during the puerperium are indeed very beneficial for the health of the mother, but have side effects of causing constipation. The paws, using param and pilis have good benefits for the body, but have a lack of itching, dust from use pollutes the place where the postpartum mother is.