The Role of Demand Factors in Utilization of Professional Care during Childbirth: Perspectives from Yemen

Abstract

Background. Utilization of professional care during childbirth by women in low-income countries is important for the progress towards MDG 5. In Yemen, home births have decreased minimally during the past decades. Objective. The study investigates the influence of socio-demographic, birth outcome and demand factors on women's future preference of a home or institutional childbirth. Method. We interviewed 220 women with childbirth experience in urban/rural Yemen. We performed bivariate chi-square tests and multiple logistic regression analysis. A multistage sampling process was used. Results. The issues of own choice, birth support and birth complications were the most important for women's preference of future location of childbirth. Women who had previously been able to follow their own individual choice regarding birth attendance and/or location of childbirth were six times more likely to plan a future childbirth in the same location and women who received birth support four times more likely. Birth complications were associated with a 2.5-fold decrease in likelihood. Conclusions. To offer women with institutional childbirth access to birth support is crucial in attracting women to professional care during childbirth. Yemeni women's low utilization of modern delivery care should be seen in the context of women's low autonomy and status.

Yemeni women’s perceptions of own authority during childbirth: What does it have to do with achieving the Millennium Development Goals?

“…Women's perceptions of the lack of interaction and listening skills of formally trained staff during childbirth were important findings in this study. Previous work from Yemen has shown that women who experienced an institutional childbirth were less willing to give birth in the same location next time than women who gave birth at home (Kempe et al, 2011). It is noteworthy, however, that in some situations, simple acts on behalf of trained staff were sufficient to meet the need for personal authority of women during childbirth in hospital.…”

“…The importance of local understanding has been emphasised in attempting to motivate women to seek biomedical care during childbirth (Asowa-Omorodion, 1997;Obermeyer, 2000;Liamputtong et al, 2005;Kempe et al, 2011). Anthropological research has found imbalances in power and knowledge central to women's reluctance to seek biomedical obstetric care, especially when local nonbiomedical resources are viewed negatively (Asowa-Omorodion, 1997;Davis-Floyd, 2003;Berry, 2006;Izugbara et al, 2009).…”

Jordanian women's dissatisfaction with childbirth care

“…; Kempe et al. ). This approach to care may lead to high levels of dissatisfaction and subsequent distress.…”

“…These factors appear to be vital contributors to levels of satisfaction. In the birthing units in Jordan and other Arab countries, healthcare providers (doctors and midwives) usually make decisions without taking the women's wishes into account (Hatamleh et al 2013;Kempe et al 2011). This approach to care may lead to high levels of dissatisfaction and subsequent distress.…”

Being Single as a Social Barrier to Access Reproductive Healthcare Services by Iranian Girls

“…The relationship between girls’ autonomy and the utilization of healthcare services is reported by antecedent studies. 27,28 A low level of reproductive health literacy and unawareness of available services were other barriers to access reproductive healthcare services stated by the participants. 29,30 …”