Agus Maryono, Banyumas – At least five mothers have reportedly died due to maternity complications over the last month in Banyumas, Central Java, allegedly due to poverty.

Banyumas Health Agency head Widayanto blamed the condition on the failure of the so-called free Jampersal (maternity insurance) program offered by the government for poor families.

"We admit that the condition is very concerning. We are investigating why this is happening at the time the government is promoting the Jampersal program," Widayanto told The Jakarta Post recently, adding that the figure was considered high.

He said that with the Jampersal program on offer, no pregnant women from poor families should be refused proper treatment by obstetriticians or midwives because they were poor.

He also expressed concern that the respective Puskesmas (community health centers) seemingly had failed to acknowledge the condition.

Widayanto said that the high rate of maternal mortality in Banyumas regency had been a reality since before he was appointed as head of the regency health agency last year.

Data at the agency shows that there were 35 cases of maternal mortality in both 2010 and 2011. "We have already had five cases in just one month this year," he said.

According to Widayanto, in most cases maternal mortality was due to poor access to doctors. "In many cases, a mother who is about to deliver and is in a critical condition needs to be referred to a particular hospital, but is not sent to that hospital by her family. As a result, late treatment often ends up in death," Widayanto said.

In other cases, he went on, patients were not sent to the referred hospital but to another hospital where they needed to undergo another basic examination, starting from the beginning again while they were already in a critical condition.

"These are a few factors that have caused high maternal mortality in Banyumas," he said. In some cases, patients were reluctant to be admitted to recommended hospitals or maternal clinics because they were afraid they could not afford the expenses.

Many maternity hospitals or clinics charge about Rp 3 million (US$333) for a normal delivery in Banyumas. The expenses for C-section surgery can reach up to Rp 10 million. "It's a lot of money for poor families who find it difficult even to afford daily meals," said Hidayah of Kembaran district, Banyumas, who had recently had a baby.

She said that she was charged Rp 3.2 million for her normal delivery. "This is already considered cheap. If you want the less expensive option you can use a midwife. They charge about Rp 800,000 for a normal birth, accounting for why poor mothers chose to go there," she said.