BACKGROUND:
Although antenatal care (ANC) coverage has improved in Indonesia, some regions—particularly those with strong traditional structures like the Minangkabau matrilineal society in West Sumatra—continue to underperform. In these communities, women hold formal authority in kinship lines, but healthcare decisions are still shaped by embedded socio-cultural dynamics that are often overlooked in conventional maternal health strategies.

OBJECTIVES:
This study explored how cultural norms, familial power hierarchies, and community beliefs influence pregnant women’s decisions to access ANC in a matrilineal setting.

METHODS:
Using a qualitative phenomenological design, the study was conducted in Nagari Pariangan, Tanah Datar Regency. Data were gathered through semi-structured interviews, focus group discussions, and community observations involving 70 informants, including pregnant women, husbands, elders, midwives, and community health volunteers. Thematic analysis was conducted using Colaizzi’s framework.

RESULTS:
Three central themes emerged: (1) decision-making power shared between women and male maternal relatives (mamak), (2) the role of local wisdom—such as bundo kanduang and sumbang duo baleh—in shaping beliefs around pregnancy, and (3) a cultural tension between communal norms and individualized biomedical care. Although women are respected figures in this society, limited knowledge, traditional misconceptions, and discomfort with health services hinder ANC engagement. Women more frequently confided in female community members than health providers.

CONCLUSIONS:
Matrilineal societies may project women’s empowerment, but socio-cultural constructs can still constrain autonomous health-seeking behaviors. A culturally responsive and community-rooted approach is essential to closing the ANC access gap.

KEY MESSAGE:
To improve maternal outcomes in culturally unique populations, health systems must adapt to local realities, integrating tradition with respectful, woman-centered care delivery. Poster session 3 (Group B)