Choice of Birthplace and Use of Birth Attendants among Child Bearing Women in Akanu, Ohafia Local Government Area, Abia State Nigeria

Abstract

Birth place and birth attendants during delivery are crucial factors in reducing maternal and newborn morbidity and mortality. This study investigated the choice of birthplace and use of birth attendants during delivery and also the factors influencing these choices among child bearing women in Akanu, Ohafia community of Abia State. The need for this study arose because women attend antenatal clinic during pregnancy but do not come to the health facility to deliver their babies; they are only seen when complications arose. Four objectives were set: To determine women’s choice of birth places in Akanu Ohafia, elicit reasons for their choice of birth places, identify women’s use of birth attendants during delivery and the factors influencing the use of birth attendants. Cross sectional descriptive survey design was adopted for the study. Total population of 313 women who gave birth between January and December 2012 were used for the study. Data were collected using researcher developed structured questionnaire. Data analysis was done using frequency counts and simple percentages and data presented in tables and pie chart. Mean and standard deviation were used for analysis of the demographic characteristics while Fishers exact test was employed in testing the two null hypotheses at 0.05 level of significance. The findings on choice of birthplace revealed that, hospital/health centre ranked highest with 67.6%, TBAS place 13.7%, church and spiritual homes 10.2 % and home 8.6%%. On the reasons for choice of birth place, respondents chose their places of delivery based on different reasons. For hospital/health centre the major reasons indicated are availability of qualified staff 93.4%, convenience 88.9% and availability of services 85.8%. On choice of TBAs place their reasons were cost 93.0%, availability 93.0% and convenience 81.4%. Reasons for using the church include availability 71.9%, labour starting at night 68.8% and charge low 62.5% while the major reason for delivering at home was that labour started at night 81.4%, Use of birth attendants during delivery showed that Nurse Midwives 70.6% is the highest and that there is reduction in the number of deliveries taken by the TBAS 15.0% and other people compared with results from other researchers. The women gave reasons which include: Provider knows her work, provider treats people with respect, the provider charges low and provider is always available as driving use of birth attendants during delivery. Two hypotheses were formulated; (i) there is no significant difference in the use of birth attendants during delivery between primiparous and multiparous women. (ii) there is no significant difference between some women’s socio demographic characteristics (age, marital status, educational level of respondent and parity) on choice of birth place. Based on the findings there should be more campaigns for mothers to use the health facilities with skilled health personnel to avert maternal death. Health services should be made available 24hours for easy access; TBAS should undergo some training to equip them for management of simple cases. Health services should be subsidized to reduce direct cost of health services on childbearing women.