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Background/AimsA delay in referring women with pregnancy complications to medical care is a significant contributor to maternal mortality worldwide. In Madura, Indonesia, these delays can be exacerbated by the role of a woman's family in decision making. This study aimed to explore family decision making in seeking healthcare for women with pregnancy complications in Madura.MethodsUsing a descriptive qualitative approach, in-depth interviews were conducted to explore the decision-making experiences of 12 pregnant women, 12 of their family members and 10 midwives.ResultsThree themes were identified: women empowerment issues, cultural factors, and important considerations in seeking healthcare for women with pregnancy complications.ConclusionsContinuous health education is needed to increase knowledge of appropriate maternal care for pregnant women and their families. The involvement of religious leaders in programmes to enhance referral decision making would be beneficial.