ABSTRAK
Keterlambatan pengambilan keputusan saat persalinan dengan komplikasiobstetri berdampak kematian ibu dan neonatal. Penelitian memahami pengambilankeputusan rujukan. Informan utama ibu dengan komplikasi obstetri saatpersalinan. Studi kasus kualitatif, purposive samplingHasil penelitian, keputusan diambil secara terpaksa. Ibu menerima rujukanhampir seluruhnya belum memahami masalah, alternatif paraji dan orang pintar.Ibu menolak rujukan belum memahami masalah, alternatif dan penanganan paraji.Persepsi kualitas pelayanan kesehatan sulit dijangkau. Proses rujukan terdapatkendala biaya, kemandirian keluarga kurang, dukungan sosial tidak tepat dandukungan bidan belum maksimal serta persepsi penanganan komplikasi obstetricukup baik.Saran : peningkatan kinerja tim, komunikasi efektif, kualitas ANC, amanatpersalinan, kemitraan paraji?bidan. Koordinasi pemetaan ibu hamil risiko tinggi,pengembangan pelayanan rujukan.

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Abstract
Delay in decision making during delivery with obstetric complication may causematernal and neonatal death. The purpose of this study to understand decisionmaking about referrals. The main informants were mothers who had obstetriccomplication during delivery. The study is a qualitative case study with purposivesampling.The result of study showed that decisions were made by force. Almost womenwho had accepted referrals did not understand the problem, alternatives bytraditional birth attendant and traditional Healing. All women who had refusedreferral have not understood the problem yet, the alternative selecting withtraditional births attended (paraji) and management with traditional birthsattended (paraji). in referal process are found that perception about health servicequality was hard to reach, money, lack of family autonomy, incorrect socialsupport and lack of midwife support but also perception about obstetriccomplication are good enough.Recommendation For Health Office the District Cianjur, Mother and BabyFriendly of Hospital Cianjur are should : Increase team work, make effectivecommunication, ensure antenatal care quality, Do plan of delivery andparthnership traditional birth attendant-midfery, Make Coordination and mappingof high risk pregnant mothers, development of referral health service.