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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2015

Open Access 01-12-2015 | Research article

Birth location preferences of mothers and fathers in rural Ghana: Implications for pregnancy, labor and birth outcomes

Authors: Leslie E. Cofie, Clare Barrington, Kavita Singh, Sodzi Sodzi-Tettey, Akalpa Akaligaung

Published in: BMC Pregnancy and Childbirth | Issue 1/2015

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Abstract

Background

Maternal deaths in Sub-Saharan Africa are largely preventable with health facility delivery assisted by skilled birth attendants. Examining associations of birth location preferences on pregnant women’s experiences is important to understanding delays in care seeking in the event of complications. We explored the influence of birth location preference on women’s pregnancy, labor and birth outcomes.

Methods

A qualitative study conducted in rural Ghana consisted of birth narratives of mothers (n = 20) who experienced pregnancy/labor complications, and fathers (n = 18) whose partners experienced such complications in their last pregnancy. All but two women in our sample delivered in a health facility due to complications. We developed narrative summaries of each interview and iteratively coded the interviews. We then analyzed the data through coding summaries and developed analytic matrices from coded transcripts.

Results

Birth delivery location preferences were split for mothers (home delivery–9; facility delivery–11), and fathers (home delivery–7; facility delivery–11). We identified two patterns of preferences and birth outcomes: 1) preference for homebirth that resulted in delayed care seeking and was likely associated with several cases of stillbirths and postpartum morbidities; 2) Preference for health facility birth that resulted in early care seeking, and possibly enabled women to avoid adverse effects of birth complications.

Conclusion

Safe pregnancy and childbirth interventions should be tailored to the birth location preferences of mothers and fathers, and should include education on the development of birth preparedness plans to access timely delivery related care. Improving access to and the quality of care at health facilities will also be crucial to facilitating use of facility-based delivery care in rural Ghana.
Literature
1.
Kinney MV, Kerber KJ, Black RE, Cohen B, Nkrumah F, Coovadia H, et al. Sub-Saharan Africa's mothers, newborns, and children: where and why do they die? PLoS Medicine. 2010;7(6):e1000294.CrossRefPubMedPubMedCentral
2.
Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, et al. Maternal mortality for 181 countries, 1980–2008: a systematic analysis of progress towards Millennium Development Goal 5. The Lancet. 2010;375(9726):1609–23.CrossRef
3.
Jamison DT, Feachem RG, Makgoba MW, Bos ER, Baingana FK, Hofman KJ, et al. Disease and Mortality in Sub-Saharan Africa. 2nd ed. World Bank: Washington (DC); 2006.
4.
Kongnyuy EJ, Hofman J, Mlava G, Mhango C, Van Den Broek N. Availability, utilisation and quality of basic and comprehensive emergency obstetric care services in Malawi. Maternal and child health journal. 2009;13(5):687–94.CrossRefPubMed
5.
Bhutta ZA, Chopra M, Axelson H, Berman P, Boerma T, Bryce J, et al. Countdown to 2015 decade report (2000–10): taking stock of maternal, newborn, and child survival. The Lancet. 2010;375(9730):2032–44.CrossRef
6.
Ronsmans C, Etard JF, Walraven G, Høj L, Dumont A, Bernis LD, et al. Maternal mortality and access to obstetric services in West Africa. Tropical Medicine & International Health. 2003;8(10):940–8.CrossRef
7.
Ghana Statistical Service. (GSS). Ghana Multiple Indicator Cluster Survey with an Enhanced Malaria Module and Biomarker: 2011 Final Report. Accra: GSS; 2011.
8.
Worku AG, Yalew AW, Afework MF. Maternal complications and women’s behavior in seeking care from skilled providers in North Gondar. Ethiopia PloS one. 2013;8(3):e60171.CrossRefPubMed
9.
Mills S, Bertrand JT. Use of Health Professionals for Obstetric Care in Northern Ghana. Studies in family planning. 2005;36(1):45–56.CrossRefPubMed
10.
Titaley CR, Hunter CL, Dibley MJ, Heywood P. Why do some women still prefer traditional birth attendants and home delivery?: a qualitative study on delivery care services in West Java Province, Indonesia. BMC Pregnancy Childbirth. 2010;10:43.CrossRefPubMedPubMedCentral
11.
Thaddeus S, Maine D. Too far to walk: Maternal mortality in context. Social Science & Medicine. 1994;38(8):1091–110.CrossRef
12.
Say L, Raine R. Public Health Reviews A Systematic Review of Inequalities in the Use of Maternal Health Care in Developing Countries : Examining the Scale of the Problem and the Importance of Context Public Health Reviews. Bulletin of the World Health Organization. 2007;85(10):812–9.CrossRefPubMedPubMedCentral
13.
14.
15.
Brighton A, D’Arcy R, Kirtley S, Kennedy S. Perceptions of Prenatal and Obstetric Care in Sub-Saharan Africa. International journal of gynaecology and obstetrics. 2013;120(3):224–27.CrossRefPubMed
16.
Tey NP, Lai SL: (2013). Correlates of and barriers to the utilization of health services for delivery in South Asia and sub-Saharan Africa. The Scientific World Journal 2013.
17.
Penfold S, Harrison E, Bell J, Fitzmaurice A. Evaluation of the delivery fee exemption policy in Ghana: population estimates of changes in delivery service utilization in two regions. Ghana medical journal. 2007;41(3):100–9.PubMedPubMedCentral
18.
Mensah J, Oppong JR, Schmidt CM. Ghana's National Health Insurance Scheme in the context of the health MDGs: An empirical evaluation using propensity score matching. Health economics. 2010;19(S1):95–106.CrossRefPubMed
19.
20.
Cham M, Sundby J, Vangen S. Maternal mortality in the rural Gambia, a qualitative study on access to emergency obstetric care. Reprod Health. 2005;2:3.CrossRefPubMedPubMedCentral
21.
Pfeiffer C, Mwaipopo R. Delivering at Home or in a Health Facility? Health-Seeking Behaviour of Women and the Role of Traditional Birth Attendants in Tanzania. BMC Pregnancy Childbirth. 2013;13:55.CrossRefPubMedPubMedCentral
22.
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.CrossRefPubMedPubMedCentral
23.
Magoma M, Requejo J, Campbell OM, Cousens S, Filippi V. High ANC coverage and low skilled attendance in a rural Tanzanian district: a case for implementing a birth plan intervention. BMC Pregnancy Childbirth. 2010;10(1):13.CrossRefPubMedPubMedCentral
24.
Amooti-Kaguna B, Nuwaha F. Factors Influencing Choice of Delivery Sites in Rakai District of Uganda. Social science & medicine. 2000;50(2):203–13.CrossRef
25.
Kululanga LI, Sundby J, Malata A, Chirwa E. Striving to promote male involvement in maternal health care in rural and urban settings in Malawi - a qualitative study. Reproductive Health. 2011;8(1):36.CrossRefPubMedPubMedCentral
26.
Carter M. Husbands and maternal health matters in rural Guatemala: wives’ reports on their spouses' involvement in pregnancy and birth. Soc Sci Med. 2002;55(3):437–50.CrossRefPubMed
27.
Carter MW, Speizer I. Salvadoran fathers’ attendance at prenatal care, delivery, and postpartum care. Rev Panam Salud Publica. 2005;18(3):149–56.CrossRefPubMed
28.
Story WT, Burgard SA, Lori JR, Taleb F, Ali NA, Hoque DE. Husbands' involvement in delivery care utilization in rural Bangladesh: A qualitative study. BMC Pregnancy Childbirth. 2012;12(1):28.CrossRefPubMedPubMedCentral
29.
Gross K, Mayumana I, Obrist B. My wife, you are supposed to have a rest now: an analysis of norms influencing men’s role in prenatal care in south-eastern Tanzania. Anthropol Med. 2013;20(1):98–108.CrossRefPubMed
30.
Kwambai TK, Dellicour S, Desai M, Ameh CA, Person B, Achieng F, et al. Perspectives of men on antenatal and delivery care service utilisation in rural western Kenya: a qualitative study. BMC Pregnancy Childbirth. 2013;13(1):134.CrossRefPubMedPubMedCentral
31.
Dudgeon MR, Inhorn MC. Men's influences on women's reproductive health: medical anthropological perspectives. Social science & medicine. 2004;59(7):1379–95.CrossRef
32.
Kabakyenga JK, Östergren PO, Turyakira E, Pettersson KO. Influence of birth preparedness, decision-making on location of birth and assistance by skilled birth attendants among women in south-western Uganda. PloS one. 2012;7(4):e35747.CrossRefPubMedPubMedCentral
33.
Guest G, Bunce A, Johnson L. How many interviews are enough? An experiment with data saturation and variability. Field methods. 2006;18:59–82.CrossRef
34.
Miles MB, Huberman AM. Qualitative data analysis: An expanded sourcebook. 2nd ed. Thousand Oaks, CA: Sage; 1994.
35.
Sandelowski M. Qualitative analysis: what it is and how to begin. Research in Nursing Health. 1995;18(4):371–5.CrossRefPubMed
36.
Gabrysch S, Cousens S, Cox J, Campbell OMR. The influence of distance and level of care on delivery place in rural Zambia: a study of linked national data in a geographic information system. PLoS medicine. 2011;8(1):e1000394.CrossRefPubMedPubMedCentral
37.
Bazzano AN, Kirkwood B, Tawiah-Agyemang C, Owusu-Agyei S, Adongo P. Social Costs of Skilled Attendance at Birth in Rural Ghana. International journal of gynaecology and obstetrics. 2008;102(1):91–4.CrossRefPubMed
38.
Jansen I. Decision making in childbirth: the influence of traditional structures in a Ghanaian village. Int Nurs Rev. 2006;53(1):41–6.CrossRefPubMed
39.
Abel NML, Françoise MK, Dramaix-Wilmet M, Donnen P. Determinants of maternal health services utilization in urban settings of the Democratic Republic of Congo--a case study of Lubumbashi City. BMC Pregnancy Childbirth. 2012;12:66.CrossRef
40.
Kitui J, Lewis S, Davey G. Factors influencing place of delivery for women in Kenya: an analysis of the Kenya demographic and health survey, 2008/2009. BMC Pregnancy Childbirth. 2013;13(1):40.CrossRefPubMedPubMedCentral
41.
Akum FA. A Qualitative Study on Factors Contributing to Low Institutional Child Delivery Rates in Northern Ghana: The Case of Bawku Municipality. Journal of Community Medicine & Health Education. 2013;03(06):1–9.CrossRef
42.
Edmonds JK, Paul M, Sibley L. Determinants of place of birth decisions in uncomplicated childbirth in Bangladesh: an empirical study. Midwifery. 2012;28(5):554–60.CrossRefPubMedPubMedCentral
43.
Moran AC, Sangli G, Dineen R, Rawlins B, Yameogo M, Baya B. Birth preparedness for maternal health: findings from Koupela District, Burkina Faso. J Health Popul Nutr. 2006;24:489–97.PubMedPubMedCentral
44.
Ganle J, Parker M, Fitzpatrick R, Otupiri E. A qualitative study of health system barriers to accessibility and utilization of maternal and newborn healthcare services in Ghana after user-fee abolition. BMC Pregnancy Childbirth. 2014;14(1):425.CrossRefPubMedPubMedCentral
45.
Crissman HP, Engmann CE, Adanu RM, Nimako D, Moyer CA. Shifting norms: pregnant women’ s perspectives on skilled birth attendance and facility – based delivery in rural Ghana. African Journal of Reproductive Health. 2013;17(1):15–27.PubMed
46.
Essendi H, Mills S, Fotso J. Barriers to Formal Emergency Obstetric Care Services’ Utilization. Journal of Urban Health. 2010;88(2):356–69.PubMedCentral
47.
Mishra A, Das A, Ottolenghi E, Huntington D, Adamchak S, Khan ME, et al. Involving men in maternity care in India. Frontiers in Reproductive Health: Population Council; 2004.
48.
Mangeni JN, Mwangi A, Mbugua S, Mukthar V. Male Involvement in Maternal Health Care as a Determinant of Utilization of Skilled Birth Attendants in Kenya. Calverton, Maryland, USA: In DHS Working Papers. Edited by International I; 2013.
Metadata
Title
Birth location preferences of mothers and fathers in rural Ghana: Implications for pregnancy, labor and birth outcomes
Authors
Leslie E. Cofie
Clare Barrington
Kavita Singh
Sodzi Sodzi-Tettey
Akalpa Akaligaung
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2015
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-015-0604-2

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