Introduction This study investigated the influence of maternal perceptions about the quality of antenatal counselling on the choice of birth attendant.

Methods A case control study was conducted between June and August 2010 in West Bandung district, Indonesia. Cases are mothers who had antenatal visits to midwife but choose paraji—a traditional birth attendant—at delivery between February and July 2010 and lived in the study area. Controls are mothers who had antenatal visits to midwife and choose midwife at delivery between February and July 2010 and lived in the study area.

Results Samples were consisted of 122 cases and 156 controls. Multivariate analyses showed that mothers who had poor perception of antenatal counselling were 1.88 times more likely to choose Paraji as birth attendant (95% CI 1.10 to 3.23). This was after controlling for other variables including maternal age, maternal education, number of deliveries, number of antenatal, decision maker and health insurance. Mothers who visited midwives who often used foreign or medical terminology during counselling were 1.7 times (95% CI 1.01 to 3) more likely to use Paraji as birth attendant. Not using visual aids also led to a preference for Paraji birth attendants (OR 2.4, 95% CI 1.31 to 4.51).

Conclusions The study suggested that poor perception about antenatal counselling steered mothers to using traditional birth attendant rather than midwives and other types of birthing care. Recommendations included providing midwives' skills in interpersonal communication and counselling, and to provide multiple choices of visual aids to support the counselling process.