Factors contributing to home delivery amongst women utilizing antenatal services in Jos University Teaching Hospital

Abstract

Background: Unskilled home delivery is a threat to maternal and child health and one of the factors associated with the very high maternal and fetal mortality is the occurrence of home deliveries as they are largely unplanned, accidental and unhygienic. The objective of this study was to determine the prevalence of home delivery among antenatal clinic attendees as well as factors contributing to their choice of place of delivery.
Methods: This was a cross sectional descriptive study that sampled the opinions of three hundred and forty (340) consenting pregnant women in Jos University Teaching Hospital using pretested and semi structured questionnaires which were self administered. Chi-squared test of statistical significance was used determine relationships between relevant variables with p value set at 0.05.
Results: The prevalence of home delivery was 23.5% and high cost of hospital deliveries was the most predominant reason for home deliveries by the participants (76.5%). Other reasons for home delivery included unexpected labour (75.6%), long distance from the health facility (66.5%) and unfriendly attitude of health workers (49.1%) amongst others. Home deliveries was significantly associated with low educational attainment (p<0.0001), polygamous family setting (p<0.05), Hausa Fulani ethnicity (p<0.0001), Islamic religion (p<0.0001) and petty trading (p<0.0001). Obstetric complications were also more likely when respondents delivered at home compared to hospital deliveries.
Conclusion: The high prevalence of home deliveries attributable to the inability of women to afford the cost of hospital deliveries shows the need for a subsidization of maternal and child health services, improved economic empowerment of women and elimination of bureaucracy and bottlenecks that increases the cost of institutional deliveries.