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The aims of this study are to assess the awareness and intention to use maternity services. This was a multicentric study involving 800 women. Educational status was the best predictor of awareness of birth preparedness (P = 0.0029), but not a good predictor of intention to attend four antenatal clinic sessions (P = 0.449). Parity was a better predictor of knowledge of severe vaginal bleeding as a key danger sign during pregnancy than educational level (P = 0.0009 and P = 0.3849, resp.). Plan to identify a means of transport to the place of childbirth was related to greater awareness of birth preparedness (χ 2 = 0.3255; P = 0.5683). Parity was a highly significant predictor (P = 0.0089) of planning to save money. Planning to save money for childbirth was associated with greater awareness of community financial support system (χ 2 = 0.8602; P = 0.3536). Access to skilled birth attendance should be promoted.

Information on fetal weight is of importance to obstetricians in the management of pregnancy and delivery. The objective of this study is to compare the accuracy of clinical and sonographic methods of predicting fetal weights at term. This prospective comparative study of 200 parturients was conducted at the University of Calabar Teaching Hospital, Calabar. The study participants were mothers with singleton term pregnancy admitted for delivery. The mean absolute percentage errors of both clinical and ultrasound methods were 11.16% ± 9.48 and 9.036% ± 7.61, respectively, and the difference was not statistically significant (P = 0.205). The accuracy within 10% of actual birth weights was 69.5% and 72% for both clinical estimation of fetal weight and ultrasound, respectively, and the difference was not statistically significant (P = 0.755). The accuracy of fetal weight estimation using Dare's formula is comparable to ultrasound estimates for predicting birth weight at term.

BackgroundMaternal mortality remains a major public health challenge, not only at the University of Calabar Teaching Hospital, but in the developing world in general.ObjectiveThe objective of this study was to assess trends in maternal mortality in a tertiary health facility, the maternal mortality ratio, the impact of sociodemographic factors in the deaths, and common medical and social causes of these deaths at the hospital.MethodologyThis was a retrospective review of obstetric service delivery records of all maternal deaths over an 11-year period (01 January 1999 to 31 December 2009). All pregnancy-related deaths of patients managed at the hospital were included in the study.ResultsA total of 15,264 live births and 231 maternal deaths were recorded during the period under review, giving a maternal mortality ratio of 1513.4 per 100,000 live births. In the last two years, there was a downward trend in maternal deaths of about 69.0% from the 1999 value. Most (63.3%) of the deaths were in women aged 20–34 years, 33.33% had completed at least primary education, and about 55.41% were unemployed. Eight had tertiary education. Two-thirds of the women were married. Obstetric hemorrhage was the leading cause of death (32.23%), followed by hypertensive disorders of pregnancy. Type III delay accounted for 48.48% of the deaths, followed by Type I delay (35.5%). About 69.26% of these women had no antenatal care. The majority (61.04%) died within the first 48 hours of admission.ConclusionAlthough there was a downward trend in maternal mortality over the study period, the extent of the reduction is deemed inadequate. The medical and social causes of maternal deaths identified in this study are preventable, especially Type III delay. Efforts must be put in place by government, hospital management, and society to reduce these figures further. Above all, there must be an attitudinal change towards obstetric emergencies by health care providers.

The aim of this paper is to propose a framework for making antenatal care an effective strategy in reducing the high maternal mortality ratio in Nigeria. On-site visits to five teaching hospitals were carried out between 2006 and 2008 to assess the practice of antenatal care. Group discussions with 200 parturients on their awareness of birth preparedness/complication readiness were conducted, in October, 2008. The findings of this study are discussed in line with the proposed practice of focused antenatal care. The practice of antenatal care in all the hospitals visited was the traditional approach based on earlier European models. Awareness of birth preparedness/complication readiness, by parturients, as a goal-directed intervention during antenatal care was low (21.5%). To reduce maternal deaths through antenatal care, it is critical to link care with detecting and treating causes of maternal mortality by a skilled attendant.