Abstract
FREQUENCY OF HOME DELIVERIES AMONG MULTIPAROUS WOMEN VISITING GYNECOLOGY OUTPATIENT DEPARTMENT OF A TERTIARY CARE HOSPITAL IN A DEVELOPING COUNTRY

Syed Muhammad Murtaza Ishaq*, Usman Haider Bhatti, Syed Furqan Shah, Muhammad Afzal Khan, Zunaira Amjad, Gohar Ur Rehman, Nukhba Maryam, Iqra Ahmad, Rehman Mehmood Bhatti, Noor ul Falah, Sundas Ali and Ayesha Amjad1

ABSTRACT

Introduction: Home deliveries are a natural way to give birth at home by assistance of skilled and unskilled birth attendants. Maternal, infant mortality and complications associated are significantly higher in home birth settings. In view of the risk factors associated with maternal mortality, international effort has been focused on the need for proper deliveries at institutional places or deliveries by trained birth attendants at home. The determinants for choosing home births include the hospital distance, transport unavailability, financial pressure, negative hospital experiences, cost effectiveness of home delivery, child birth order number is another determinant in developing countries. Objectives:  To find the proportion of women who are undergoing home deliveries.  To find the frequency of complications associated with mother and neonate by delivery at home. Study design: Case series study was conducted from September 1, 2019 to October 1, 2019. Study settings: Gynecology Outpatient department of Services Hospital Lahore. Subjects: Multiparous women visiting Gynecology Outpatient department of Services hospital Lahore. Methods: Multiparous women visiting Gynecology Outpatient Department of Services Hospital, were enrolled and interviewed. Socio-demographic characteristics, knowledge and attitudes were compared using Chi square test and independent t tests among those who delivered at home and those who did not. Results: 92 women were interviewed from September 1, 2019 to October 1, 2019 in ante-natal settings, 25.6% of women had home deliveries and 74.3% women had hospital deliveries. Complications caused by children to mothers during pregnancy at home, during birth at home and after at home was found out to be 10.1%, 4.2% and 2.4% respectively. Similarly, complications associated with children during pregnancy, during birth at home and after birth at home was found out to be 7%, 2.4%, 0.35% respectively. The percentage of stillborn births was 1.4%. It shows that out of total 285 births 207 were done by doctors which is 72.6%. Trained birth attendant or Dai delivered 22.1% babies. Similarly Lady health visitor and Lady health worker delivered 2.4% and 1.7% respectively, birth by others like in emergency cases were 1.0%. The home births were more in illeterate women of rural areas. The two most important factors for choosing home births were safe home environment( 26.1%) prevalent and distant hospital(16.5%). Conclusion: Several factors were identified for women who were not undergoing home delivery, among which the most important were unavailability of skilled birth attendants, and increased incidence of maternal and neonatal mortality associated with deliveries at home by Dai’s or Traditional birth attendants. The burden on hospitals can be reduced if we emphasize the importance of skilled birth attendants for safe deliveries at home with the reduction of maternal and neonatal morbidity and mortality.

Keywords: Multiparous, case series study.


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