Birth Place, Practices - A Research Agenda

Abstract

Background: Risk for mothers, newborns dying are believed to be higher in home than hospital births, but homebirths, research continue. Objective: Present study was done to know place of birth, mode of delivery, outcome, satisfaction/dissatisfaction amongst tribal women in hilly forestry region with limited resources. Material Methods: From 52 villages where togetherness with communities was being developed, women, 20 to 35 yrs, with at least one birth within 5 years were interviewed. Results: Of 520 births, 229 (44%) had hospital, 291 (56%) home births. Experience was good in 179(78%), because had known that in case of complications, were at safe place, in safe hands. Fifty women (22% hospital births) were not happy, 22(12.2%) said, lost wages, 4.36% for other reasons, could not explain. Overall 225 had vaginal births, 220 in government, five at private hospitals. Of 223 public hospital births, 38% were in subdistrict hospital, 60% at primary health centers (133 normal + 1 breech), 5 (around 1% of all) at district, 6 (1% of all) at private hospital. Of 291 home births, 179 (61%) were conducted by Untrained Traditional Birth Attendants. Of 210 women of 20-25 years, 29 (13.8%) did not get time to go to hospital, 4 (1.9) did not have anyone, 20 (9.5%) had transport problem, 115 (39%) felt comfortable delivering at home. Majority 287 of 291(98.6%) home births, did not have any problem, were satisfied. Of 521 births in 520 women, 87 (16.6%) were obvious preterm. There were 13(2.49%) SB, 01 - (0.19%) early NND. FGDs revealed women believed TBAs did good job, were competent to deliver even when complications, were scared of operative hospital procedures. Other reasons were difficulties of going to hospital, lost resources, some felt shy. Care for mothers newborns in ways that made sense to women, babies, health workers is essential.