Grandmultiparity: Reasons for the index pregnancy

Abstract

Background: Grandmultiparity still constitutes a significant obstetric problem in the developing countries. Although the socio-demographic
characteristics of the grandmultiparae are known, little is documented about the reasons for their index pregnancy. Such knowledge is key to an
effective counseling and advocacy strategies to reduce the incidence of this obstetric problem.
Objective: This study is aimed at finding out the reasons for the index pregnancy among the grandmultiparous women. The knowledge and use of family planning methods was also analyzed.
Setting: The Antenatal clinic of the Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra-State
Design/Subjects: A cross sectional study of 435 consecutive grandmultiparous women who booked for antenatal care in the hospital over a 6-month period (1st June 2007- 30th November 2007)
Methods: Structured questionnaires were interviewer- administered to the women. Information requested includes the reasons for the index
pregnancy, knowledge and usage of family planning methods and socio-demographic characteristics.

Result: The women interviewed were predominantly traders (71.30%), of Para 5 (44.00% ) and within the age range of 30-39years (72.20%.).
76.20% of them were aware of family planning methods while 12.8% had ever used modern methods of family planning. The reasons given for the
index pregnancy were miscalculation of safe period, (47.60 %,) desire for a male child (31.30), husband’s wish (7.6%), failed contraception (3.5%)
and loss of off springs (2.80%)
Conclusion: Poor usage of family planning methods and the desire for a male child are the major reasons why grandmultiparous women get pregnant in our environment. Health education and community sensitization towards improved utilization of family planning methods as well reduced preference of the male child will reduce the incidence of this obstetric problem.