IFGH 2012: An Examination of Women Experiencing Normal Deliveries and Obstetric Complications Requiring Emergency Care: Socio Cultural Consequences of Increasing Caesarean Sections in Bangladesh

Authors:Blum LS., Sultana M., Bilkis S., Koblinsky M.


Author Affiliations:International Centre for Diarrheal Disease Research, Bangladesh (ICDDR,B)

Option 1– Scientific / Empirical Research Findings Presented as – Poster (unable to present)

Aims:

Historically, there has been a strong cultural preference for home births in Bangladesh. Recent findings show socioeconomic disparities in use of emergency obstetric care, highlighting the need to examine deliveries, including caesarean sections. The objective of the study was to understand the community perceptions towards home and hospital deliveries and its consequences on women and families.

Methods:

Qualitative research involving in-depth interviews was carried out with 19 women who had experienced normal deliveries and 20 women who had severe complications during delivery in rural Bangladesh between March 2008 and August 2009.

Results:

Women were poorly informed about pregnancy-related complications and medical indications for emergency care prior to delivery. Findings highlighted the barriers women faced with severe complications in reaching emergency obstetric facilities. Women who had caesarean sections incurred huge costs that led to economic burdens on family members and blame attributed to the woman. Both women with normal and severe deliveries reported many health consequences postpartum, which were generally left untreated.

Conclusions:

The data underline the importance of educating women and their families about pregnancy-related complications and preparing for the possibility of caesarean section. At the same time, health systems need to be strengthened to ensure that all women in clinical need of life-saving obstetric surgery can obtain a caesarean section. While greater access to surgical interventions is likely linked to recent reductions in maternal mortality in Bangladesh, policy makers need to institute mechanisms to discourage the over medicalisation of childbirth in a context where use of caesarean section is rapidly rising.