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Current Women`s Health Reviews


ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

Research Article

Why Do Pregnant Mothers Prefer to Give Birth at Home After they Attended Antenatal Care Visits in Southern Ethiopia? A Phenomenological Study Design

Author(s): Tesfaye Temesgen and Zerihun Figa*

Volume 20, Issue 1, 2024

Published on: 15 February, 2023

Article ID: e200123212963 Pages: 7

DOI: 10.2174/1573404819666230120122906

Price: $65


Background: Common causes of maternal deaths are direct obstetric complications that can be managed by healthcare providers in health facilities. Women giving birth at home have a higher contribution to maternal mortality and morbidity as well as a poor fetal outcome. Sub-Saharan Africa accounts for an estimated 66% of all maternal deaths. This study aimed to explore why pregnant mothers prefer to deliver at home after antenatal care follow-up in South Ethiopia.

Methods: Phenomenological study design was used to explore the factors that push women to home delivery despite antenatal care being provided. A purposive technique was used to recruit the twenty pregnant mothers for the focused group discussion and ten healthcare providers for an in-depth interview. The data saturation approach determined the sample size. A focused group discussion was commenced with women who had ANC follow-ups during pregnancy gave birth at home and came for immunization services in health facilities. The in-depth interview was done with physicians, midwives, health officers, and traditional birth attendants. Data were translated into English by a bilingual translator and analyzed thematically using Open Code software. The result was presented in a table and text.

Results: The study includes a total of 20 women for FGDs, seven health professionals, and three traditional birth attendants from selected health facilities. The age of most FGD participants was 25-35 years. The ideas of the participants were grouped into five themes and subthemes. Fear of health professionals’ disrespect and abuse, a family decision on the place of delivery, lack of transport and money, traditional birth attendants’ acceptability by the community, and sociocultural influences were commonly raised as barriers to institutional delivery.

Conclusion: Most of the barriers are related to behavioural issues, and effort should be made to change the behaviour of the community in general. Improving the quality of the antenatal care service and adequate counseling may be an appropriate intervention to increase health facilities' delivery.

Keywords: Home delivery, antenatal care, Ethiopia, maternal mortality, morbidity, open code software.

Graphical Abstract
Ronsmans, C.; Graham, W.J. Maternal mortality: Who, when, where, and why. Lancet, 2006, 368(9542), 1189-1200.
[] [PMID: 17011946]
Barber, T.; Rogers, J.; Marsh, S. Increasing out-of-hospital births: What needs to change? Br. J. Midwifery, 2007, 15(1), 16-20.
Levy, V. Maintaining equilibrium: A grounded theory study of the processes involved when women make informed choices during pregnancy. Midwifery, 1999, 15(2), 109-119.
[] [PMID: 10703414]
Tafere, TE; Afework, MF; Yalew, AW Antenatal care service quality increases the odds of utilizing institutional delivery in bahir dar city administration, north western Ethiopia : A prospective follow up study., 2018, 1-14.
Chao, F.; You, D.; Pedersen, J.; Hug, L.; Alkema, L. National and regional under-5 mortality rate by economic status for low-income and middle-income countries: A systematic assessment. Lancet Glob. Health, 2018, 6(5), e535-e547.
[] [PMID: 29653627]
Wolde, H.F.; Gonete, K.A.; Akalu, T.Y.; Baraki, A.G.; Lakew, A.M. Factors affecting neonatal mortality in the general population: Evidence from the 2016 Ethiopian Demographic and Health Survey (EDHS)-multilevel analysis. BMC Res. Notes, 2019, 12(1), 610.
[] [PMID: 31547855]
Darmstadt, G.L.; Bhutta, Z.A.; Cousens, S.; Adam, T.; Walker, N.; de Bernis, L. Evidence-based, cost-effective interventions: How many newborn babies can we save? Lancet, 2005, 365(9463), 977-988.
[] [PMID: 15767001]
Graham, W.J.; Bell, J.S.; Bullough, C.H. Can skilled attendance at delivery reduce maternal mortality in developing countries?, 2001, 33
Teferra, A.S.; Alemu, F.M.; Woldeyohannes, S.M. Institutional delivery service utilization and associated factors among mothers who gave birth in the last 12 months in Sekela district, North West of Ethiopia: A community - based cross sectional study. BMC Pregnancy Childbirth, 2012, 12(1), 74.
[] [PMID: 22849421]
Ethiopian Public Health Institute (EPHI) (Ethiopia) and ICF. 2021. Ethiopia Mini Demographic and Health Survey 2021, Final Report. Rockville, Maryland, USA: EPHI and ICF.
Tesfaye, B.; Mathewos, T.; Kebede, M. Skilled delivery inequality in Ethiopia: To what extent are the poorest and uneducated mothers benefiting? Int. J. Equity Health, 2017, 16(1), 82.
[] [PMID: 28511657]
Tilahun, W.; Bekana, F.; Biru, A. Magnitude of home delivery and associated factors among antenatal care booked mothers in Delanta district, South Wollo zone, North East Ethiopia: A cross-sectional study. Int. J. Womens Health Wellness, 2018, 4(2), 1.
Mulat, A.; Kassa, S.; Belay, G.; Emishaw, S.; Yekoye, A.; Bayu, H.; Kebede, S. Missed antenatal care follow-up and associated factors in Eastern Zone of Tigray, Northern Ethiopia. Afr. Health Sci., 2020, 20(2), 690-696.
[] [PMID: 33163033]
Abdella, M; Abraha, A; Gebre, A; Surender Reddy, P. Magnitude and associated factors for home delivery among women who gave birth in last 12 months in Ayssaita, Afar, Ethiopia-2016. A community based cross sectional study. Glob J Fertil Res., 2017, 2(1), 030-039.
Hailu, D.; Tadele, H.; Tadesse, B.T.; Alemayehu, A.; Abuka, T.; Woldegebriel, F. Home delivery practice and its predictors in South Ethiopia. PLoS One, 2021, 16(8)e0254696
Girum, T.; Wasie, A. Correlates of maternal mortality in developing countries: An ecological study in 82 countries. Matern. Health Neonatol. Perinatol., 2017, 3(1), 19.
[] [PMID: 29142757]
Batist, J. An intersectional analysis of maternal mortality in Sub-Saharan Africa: a human rights issue. J. Glob. Health, 2019, 9(1)010320
[] [PMID: 31217956]
Stokoe, U. Determinants of maternal mortality in the developing world. Aust. N. Z. J. Obstet. Gynaecol., 1991, 31(1), 8-16.
[] [PMID: 1872781]
Bedilu, K.; Niguse, M. Delivery at home and associated factors among women in child bearing age, who gave birth in the preceding two years in Zala Woreda, Southern Ethiopia. J. Public Health Epidemiol., 2017, 9(6), 177-188.
Wondimu, M.S.; Woldesemayat, E.M. Determinants of home delivery among women in rural pastoralist community of Hamar district, Southern Ethiopia: A case–control study. Risk Manag. Healthc. Policy, 2020, 13, 2159-2167.
[] [PMID: 33116994]
Terefe, G.; Teha, A.; Diribsa, T.; Abdisa, D. Extent of home delivery among women who gave birth in the last one year in Serbo, Kersa Woreda, Jimma zone, Oromia region, Southwest Ethiopia. Obstet. Gynecol. Int., 2022, 1-9.
[] [PMID: 35082848]
Kasaye, H.K.; Endale, Z.M.; Gudayu, T.W.; Desta, M.S. Home delivery among antenatal care booked women in their last pregnancy and associated factors: Community-based cross sectional study in Debremarkos town, North West Ethiopia, January 2016. BMC Pregnancy Childbirth, 2017, 17(1), 225.
[] [PMID: 28705188]
Akum, F.A. A qualitative study on factors contributing to low institutional child delivery rates in Northern Ghana: The case of bawku municipality. J. Community Med. Health Educ., 2013, 3(6)
Sychareun, V.; Hansana, V.; Somphet, V.; Xayavong, S.; Phengsavanh, A.; Popenoe, R. Reasons rural Laotians choose home deliveries over delivery at health facilities: A qualitative study. BMC Pregnancy Childbirth, 2012, 12(1), 86.
[] [PMID: 22925107]
Scott, N.A.; Henry, E.G.; Kaiser, J.L.; Mataka, K.; Rockers, P.C.; Fong, R.M.; Ngoma, T.; Hamer, D.H.; Munro-Kramer, M.L.; Lori, J.R. Factors affecting home delivery among women living in remote areas of rural Zambia: A cross-sectional, mixed-methods analysis. Int. J. Womens Health, 2018, 10, 589-601.
[] [PMID: 30349403]
Wako, W.G.; Kassa, D.H. Institutional delivery service utilization and associated factors among women of reproductive age in the mobile pastoral community of the Liban District in Guji Zone, Oromia, Southern Ethiopia: A cross sectional study. BMC Pregnancy Childbirth, 2017, 17(1), 144.
[] [PMID: 28506226]
Abebe, E.; Seid, A.; Gedefaw, G.; Haile, Z.T.; Ice, G. Association between antenatal care follow-up and institutional delivery service utilization: Analysis of 2016 Ethiopia demographic and health survey. BMC Public Health, 2019, 19(1), 1472.
[] [PMID: 31699062]
Fekadu, A.; Yitayal, M.; Alemayehu, G.A.; Abebe, S.M.; Ayele, T.A.; Tariku, A.; Andargie, G.; Teshome, D.F.; Gelaye, K.A. Frequent antenatal care visits increase institutional delivery at dabat health and demographic surveillance system site, Northwest Ethiopia. J. Pregnancy, 2019, 2019, 1-6.
[] [PMID: 30809397]

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