Predictors and birth outcomes: An investigation of birth and emergency preparedness among postnatal women at a national referral hospital in Accra, Ghana

Abstract

Objective: Birth and emergency preparedness is a safe motherhood strategy which encourages early decision making and minimizes delays in health care seeking in the event of obstetric complications. The aim of this study was to determine individual level factors influencing birth and emergency preparedness.
Methods: A cross sectional, hospital based survey was conducted among 483 postnatal women at a national referral hospital in Accra, Ghana. Eligible women were consenting postnatal attendees aged 15-49 years who had a birth in the two months preceding the survey. Study subjects were recruited serially during routine postnatal clinic visits between March and December, 2011. Interviews were conducted using purpose designed, structured questionnaires and collected data was based on maternal reports of recent pregnancy and childbirth experience. Predictors of awareness and adequate knowledge of danger signs, having a birth plan, and a stable birth outcome were determined using Pearson’s Chi-Square test and binary logistic regression analysis.
Results: Educational status was a predictor of awareness of obstetric danger signs. Secondary education and formal employment were predictors of adequate knowledge. Older age (>30 years), formal employment and awareness of any obstetric danger sign were predictors of having a birth plan. Having a birth plan was not predictive of a stable birth outcome after controlling for confounders. Absence of maternal or newborn complications was highly predictive of a stable outcome.
Conclusions: Women’s empowerment through better education and formal employment is recommended to enhance birth preparedness and access to skilled maternity care. Birth outcomes may be dependent on factors other than having a birth plan; this requires further exploration.

Key words: birth preparedness, factors, pregnancy, Ghana