Mothers employed in paid work and their predictors for home delivery in Pakistan

Abstract

BackgroundPakistan has one of the highest rates of maternal and neonatal mortality in the world. It is assumed that employed mothers in paid work will be more empowered to opt for safer institutional deliveries. There is a need to understand the predictors of home deliveries in order to plan policies to encourage institutional deliveries in the region.MethodsThe study aimed to ascertain the predictors for home deliveries among mothers employed in paid work in Pakistan. Data analysis is based on secondary data taken from the Pakistan Demographic Health Survey 2012–13. Bivariate and multivariate logistic regression models were conducted.ResultsThe findings show that the majority (53.6%) of employed mothers in Pakistan give birth at home. Employed mothers in paid work with the following characteristics had higher chances for delivering at home: (i) women from rural areas (AOR 1.26; 95% CI: 0.94–1.71), or specific regions within Pakistan, (ii) those occupied in unskilled work (AOR 2.61; 95% CI: 1.76–3.88), (iii) women married to uneducated (AOR 1.70; 95% CI: 1.08–2.66), unemployed (AOR 1.69; 95% CI: 1.21–2.35), or unskilled men (AOR 2.02; 95% CI: 1.49–2.72), (iv) women with more than 7 children (AOR 1.57; 95% CI: 1.05–2.35), (v) women who are unable in the prenatal period to have an institutional check-up (AOR 4.84; 95% CI: 3.53–6.65), take assistance from a physician (AOR 3.98; 95% CI: 3.03–5.20), have a blood analysis (AOR 2.63; 95% CI: 1.95–3.57), urine analysis (AOR 2.48; 95% CI: 1.84–3.33) or taken iron tablets (AOR 2.64; 95% CI: 2.06–3.38), and (vi) are unable to make autonomous decisions with regard to spending their earnings (AOR 1.82; 95% CI: 1.27–2.59) and healthcare (AOR 1.12; 95% CI: 0.75–1.65).ConclusionsGreater efforts by the central and provincial state bodies are needed to encourage institutional deliveries and institutional access, quality and cost. Maternal and paternal benefits are needed for workers in both the formal and informal sectors of the economy. Finally, cultural change, through education, media and religious authorities, is necessary to support institutional deliveries and formal sector paid employment and out of home work opportunities for mothers of Pakistan.

Spatio-temporal distribution and associated factors of home delivery in Ethiopia. Further multilevel and spatial analysis of Ethiopian demographic and health surveys 2005–2016

“…The uptake of health facility delivery decreased with high birth order and parity of 2-5, which is consistent with the study conducted in different countries [26,34,40,41]. This might be the service quality given in previous births.…”

What influences home delivery among women who live in urban areas? Analysis of 2014 Ghana Demographic and Health Survey data

“…Evidence suggests that home births among women in SSA pose high risks to the health of the mother and the child during the period after delivery [ 13 – 15 ]. Some of these risks include desertion of colostrum provision and breastfeeding practices, neglect of immunisations and nutrition supplementation for mother and child, and lack of postnatal care check-up for the child and mother [ 16 – 18 ].…”

Factors Affecting Delivery Health Service Satisfaction of Women and Fear of COVID− 19: Implications for Maternal and Child Health in Pakistan

“…The most recent nationwide data from the Pakistan Demographic Health Survey reports that 34% of women do not opt for institutions for safe deliveries (National Institute of Population Studies, 2017 – 18 ). The reasons for not choosing institutional deliveries in the country include the following: (i) preference for home deliveries and traditional midwives of the community (Sarfraz & Hamid, 2014 ); (ii) fear that institutional staff will force unnecessary C-sections (Nazir, 2015 ); (iii) inability to access or pay for institutional deliveries (Jafree et al, 2018 ); and (iv) lack of permission from husband and in-laws (Agha, 2011 ). During the coronavirus pandemic, additional fear exists that many women might revert to home deliveries if they hear about lack of safety and preventive precautions being practiced in hospitals and health centers.…”