Prolonged Labour in Rural Ethiopia: A Community Based Study

Abstract

Obstructed or prolonged labour is one of the major causes of maternal death, and it is associated with poor child survival in developing countries. The aim of this study was to determine the risk factors for, and outcome of, and outcome, prolonged labour among rural women giving birth at home. A prospective community-based study of pregnant women in rural communities of South central Ethiopia was conducted using lay female interviewers. Labour of more than 24 hours was observed in 181(14.7%) women, 17.2 per cent among primipara and 14.2 per cent among multipara. The incidence rates of poor pregnancy outcome were stillbirth (19/1000 births), perinatal mortality (45/1000 births) and neonatal mortality (37/1000 live births). Poor birth outcomes were higher among women with labour > 24 hours than for women with labour <12 hours. Among primipara, stillbirth [RR 2.21, (95% CI 0.89, 5.52)], perinatal mortality [RR 3.10, (95% CI 1.84, 5.23)] and neonatal mortality [RR 3.10, (95% CI 1.70, 5.65)]. Among multipara, stillbirth [RR 2.15, (95% CI 0.0.95, 4.85)], perinatal mortality [RR 4.03, (95% CI 2.86, 6.06)], and neonatal mortality [RR 4.61, (95% CI 3.20, 6.63)]. Also, 36.7% of all perinatal deaths among primiparas and 16.7% among multiparas were associated with prolonged labour. Maternal height and low birth weight were associated with prolonged labour among primipara. Prolonged labour is a serious reproductive health problem contributing significantly to the risk of perinatal death. (Afr J Reprod Health 1999; 3 [2]: 33-39)


Key Words: Labour, foetal death, home, childbirth, rural population, Ethiopia