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Are women deciding against home births in low and middle income countries?

Are women deciding against home births in low and middle income countries?
Are women deciding against home births in low and middle income countries?
Background
Although there is evidence to tracking progress towards facility births within the UN Millennium Development Goals framework, we do not know whether women are deciding against home birth over their reproductive lives. Using Demographic and Health Surveys (DHS) data from 44 countries, this study aims to investigate the patterns and shifts in childbirth locations and to determine whether these shifts are in favour of home or health settings.

Methods and Findings
The analyses considered 108,777 women who had at least two births in the five years preceding the most recent DHS over the period 2000–2010. The vast majority of women opted for the same place of childbirth for their successive births. However, about 14% did switch their place and not all these decisions favoured health facility over home setting. In 24 of the 44 countries analysed, a higher proportion of women switched from a health facility to home. Multilevel regression analyses show significantly higher odds of switching from home to a facility for high parity women, those with frequent antenatal visits and more wealth. However, in countries with high infant mortality rates, low parity women had an increased probability of switching from home to a health facility.

Conclusions
There is clear evidence that women do change their childbirth locations over successive births in low and middle income countries. After two decades of efforts to improve maternal health, it might be expected that a higher proportion of women will be deciding against home births in favour of facility births. The results from this analysis show that is not the case.
1932-6203
e65527
Amoako Johnson, Fiifi
e348fd15-9fe2-472f-a701-2980b8cec4d5
Padmadas, Sabu S.
64b6ab89-152b-48a3-838b-e9167964b508
Matthews, Zoë
ebaee878-8cb8-415f-8aa1-3af2c3856f55
Amoako Johnson, Fiifi
e348fd15-9fe2-472f-a701-2980b8cec4d5
Padmadas, Sabu S.
64b6ab89-152b-48a3-838b-e9167964b508
Matthews, Zoë
ebaee878-8cb8-415f-8aa1-3af2c3856f55

Amoako Johnson, Fiifi, Padmadas, Sabu S. and Matthews, Zoë (2013) Are women deciding against home births in low and middle income countries? PLoS ONE, 8 (6), e65527. (doi:10.1371/journal.pone.0065527).

Record type: Article

Abstract

Background
Although there is evidence to tracking progress towards facility births within the UN Millennium Development Goals framework, we do not know whether women are deciding against home birth over their reproductive lives. Using Demographic and Health Surveys (DHS) data from 44 countries, this study aims to investigate the patterns and shifts in childbirth locations and to determine whether these shifts are in favour of home or health settings.

Methods and Findings
The analyses considered 108,777 women who had at least two births in the five years preceding the most recent DHS over the period 2000–2010. The vast majority of women opted for the same place of childbirth for their successive births. However, about 14% did switch their place and not all these decisions favoured health facility over home setting. In 24 of the 44 countries analysed, a higher proportion of women switched from a health facility to home. Multilevel regression analyses show significantly higher odds of switching from home to a facility for high parity women, those with frequent antenatal visits and more wealth. However, in countries with high infant mortality rates, low parity women had an increased probability of switching from home to a health facility.

Conclusions
There is clear evidence that women do change their childbirth locations over successive births in low and middle income countries. After two decades of efforts to improve maternal health, it might be expected that a higher proportion of women will be deciding against home births in favour of facility births. The results from this analysis show that is not the case.

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More information

Published date: 14 June 2013
Organisations: Social Statistics & Demography

Identifiers

Local EPrints ID: 353814
URI: https://eprints.soton.ac.uk/id/eprint/353814
ISSN: 1932-6203
PURE UUID: 5e460de0-690c-4ebd-92b0-cc9f758046f1
ORCID for Sabu S. Padmadas: ORCID iD orcid.org/0000-0002-6538-9374

Catalogue record

Date deposited: 19 Jun 2013 09:28
Last modified: 29 Sep 2018 00:33

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