IFGH 2012: Childbirth Planning and Preparation: Findings from the Qualitative Assessment of the Bangladesh Maternal Mortality Survey (BMMS), 2010

Authors:Blum L.S, Sultana M., Bilkis S., Nahar Q., Streatfield PK.


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

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

Aims:

Only 27% of Bangladeshi women deliver with skilled birth attendants. Antenatal care (ANC) serves as an opportunity for health workers to inform women about essential birth preparations, particularly related to childbirth complications. In order to increase use of skilled attendants and improve birth outcomes, it is important to understand how women view birth preparedness and plans they make prior to delivery.

Methods:

As a sub-component of a nationwide maternal mortality survey, in-depth interviews was carried out between March 2010 and February 2011 with 20 women in their third trimester of pregnancy to assess what preparations they had made for childbirth. When available the pregnant woman’s husband, mother and mother-in-law were also questioned.

Results:

Women attended on average two antenatal visits, with approximately one-third never receiving ANC. Health workers providing ANC consistently failed to give information on pregnancy-related complications or advice on place of delivery. The vast majority of respondents expected to deliver at home with a traditional birth attendant (TBA) because they assumed the delivery would be normal, had confidence in the TBA, and wanted to avoid a facility delivery. Despite the fact that women also know that delivery can be risky, most women failed to discuss childbirth with household decision-makers. Women expressed multiple reservations about giving birth in a health center, with most frequent concerns relating to costs and shame in exposing private body parts to male health workers. While all women indicated that they would go to a health facility if complications occurred, virtually no preparations had been made in regard to transport and savings to pay for emergency care.

Conclusions:

Although childbirth is viewed as a dangerous time, minimal preparations are made prior to delivery. ANC health workers often fail to provide valuable information for birth planning. Efforts are needed to improve ANC so that women and their families are better prepared to respond to delivery complications.