THE UNIVERSITY OF HULL An Ethnographic Study of Women's Experiences of Breastfeeding in the Karo Highlands of Indonesia being a Thesis Submitted for the Degree of Doctor of Philosophy in the University of Hull by Milda Longgeita Pinem S.Sos. (B.A.) in Social Development (Universitas Gadjah Mada, Yogyakarta, Indonesia) M.A. in Political Science (Universitas Gadjah Mada, Yogyakarta, Indonesia) September 2018 Contents LIST OF TABLES .......................................................................................................... IV ACKNOWLEDGEMENTS ........................................................................................... VI ABSTRACT .................................................................................................................... VII CHAPTER 1. INTRODUCTION ..................................................................................... 1 1.1. BRINGING BREASTFEEDING INTO THE MAINSTREAM ............................................... 6 1.1.1. Global Context ................................................................................................. 10 1.1.2. Indonesia Context ............................................................................................ 16 1.1.3. Breastfeeding Research in the Indonesia Context ........................................... 20 CHAPTER 2. LITERATURE REVIEW ....................................................................... 25 2.1. THE THEORETICAL FRAMEWORK ........................................................................... 25 2.2. THE ANALYTICAL FRAMEWORKS FOR BREASTFEEDING STUDIES ......................... 31 2.2.1. Motherhood ...................................................................................................... 31 2.2.2. Bodies and Breasts ........................................................................................... 35 2.2.3. Spaces .............................................................................................................. 39 2.2.4. Mother-Family Member Relationships ............................................................ 43 2.2.5. Ethnographic Studies of Breastfeeding ............................................................ 46 2.3. CONCLUSION ........................................................................................................... 51 CHAPTER 3. METHODOLOGY .................................................................................. 53 3.1. FEMINIST ETHNOGRAPHY AS A METHODOLOGY .................................................... 53 3.2. JOURNEY TO KAROLAND ........................................................................................ 57 3.3. RESEARCH PARTICIPANTS ....................................................................................... 59 3.4. DATA-GATHERING .................................................................................................. 67 3.4.1. Participant Observation .................................................................................. 69 3.4.2. Formal Interview ............................................................................................. 71 3.4.3. Informal Conversations ................................................................................... 73 3.4.4. Leaving the Research Location ........................................................................ 74 3.5. DATA ANALYSIS AND WRITING .............................................................................. 75 3.7. CONCLUSION ........................................................................................................... 78 CHAPTER 4. UNDERSTANDING KARO .................................................................. 79 4.1. HISTORICISING AND IMAGINING KARO IN INDONESIA ........................................... 80 4.2. THE MEANING OF ETHNICITY: MERGA SILIMA, LANGUAGE AND CLOTHING ............. 94 4.2.1. Merga Silima and Beru Silima ......................................................................... 95 4.2.2. Karo Language .............................................................................................. 103 4.2.3. Uis Gara: From Karo Clothing to Karo Fashion ......................................... 107 4.3. CHURCH ................................................................................................................ 110 4.4. CONCLUSION ......................................................................................................... 114 CHAPTER 5. INSTITUTIONAL PERSPECTIVES ON MOTHERHOOD AND BREASTFEEDING IN KAROLAND ......................................................................... 115 5.1. MOTHERHOOD IN KAROLAND ............................................................................... 116 5.1.1. Ibu and Nande ................................................................................................ 116 5.1.2. Colonialism .................................................................................................... 120 5.1.3. Post-colonialism: Lady Kartini and Kebaya ................................................. 122 5.2. STATE REGULATIONS ON CHILD NUMBERS AND BREASTFEEDING ...................... 128 5.2.1. Keluarga Berencana (Family Planning) ....................................................... 128 5.2.2. Exclusive Breastfeeding ................................................................................. 135 5.3. MARY “MOTHER OF JESUS”: THE CHURCH’S VIEW OF MOTHERHOOD ................ 138 ii 5.3.1. Breastfeeding for Religious Mothers ............................................................. 143 5.4. CONCLUSION ......................................................................................................... 145 CHAPTER 6. NEGOTIATING INSTITUTIONAL BREASTFEEDING: KARO MOTHERS’ EXPERIENCES ...................................................................................... 147 6.1. IGNORANCE AND AMBIVALENCE TOWARDS THE BREASTFEEDING LAW ............. 148 6.1.1. The Law is not the Reason ............................................................................. 150 6.1.2. No Preparation for Breastfeeding during Pregnancy ................................... 153 6.1.3. Bottle-Feeding Practices ............................................................................... 156 6.1.4. Feeding on Demand ....................................................................................... 160 6.1.5. Hygiene .......................................................................................................... 165 6.1.6. Weaning and Stopping Breastfeeding ............................................................ 169 6.2. BETWEEN PRAGMATIC AND RELIGIOUS MOTHERS .............................................. 172 6.3. NEITHER TRADITIONAL NOR MODERN ................................................................. 175 6.4. CONCLUSION ......................................................................................................... 180 CHAPTER 7. DEALING WITH BODY AND SPACE ISSUES IN BREASTFEEDING ....................................................................................................... 182 7.1. BODY IMAGE IN BREASTFEEDING ......................................................................... 183 7.1.1. Being a Breastfeeding Mother is Being Fat ................................................... 184 7.1.2. Reliable Mothers Do Not Wear Make Up ...................................................... 193 7.1.3. Breasts Are Not Sexual .................................................................................. 197 7.2. THE MEANING OF SPACE IN THE STATE OF BREASTFEEDING ............................... 202 7.2.1. Breastfeeding in Communal Spaces .............................................................. 203 7.2.2. Gendered Characters of the Spaces ............................................................... 209 7.2.3. No Lactation Rooms ...................................................................................... 214 7.3. CONCLUSION ......................................................................................................... 216 CHAPTER 8. THE ROLE OF GRANDMOTHERS IN BREASTFEEDING PRACTICES .................................................................................................................. 217 8.1. THE POWER OF GRANDMOTHERS IN BREASTFEEDING ......................................... 217 8.1.1. Who are Grandmothers in Karo Families? ................................................... 218 8.1.2. The Past Experiences of Grandmothers in Breastfeeding Practices ............. 223 8.1.3. The Influence of Grandmothers in Breastfeeding Practices .......................... 229 8.2. THE MOTHERS’ DEALINGS WITH THE GRANDMOTHERS ...................................... 234 8.5. CONCLUSION ......................................................................................................... 241 CHAPTER 9. SUMMARY AND CONCLUSION ...................................................... 243 9. 1 LOCATING THE RESEARCH IN THE DISCOURSE OF ETHNOGRAPHIES OF BREASTFEEDING .......................................................................................................... 251 9.2 RECOMMENDATIONS FOR PRACTICE AND FUTURE RESEARCH ............................. 254 9.3 FINAL REFLECTIONS .............................................................................................. 256 REFERENCES .............................................................................................................. 259 iii List of Tables Table 1. Total and Percentage