Incidence and predictors of women’s place of delivery among pregnant women who received antenatal care in Southern Ethiopia: a prospective cohort study

Abstract

Background

Home delivery is responsible for a high number of maternal and newborn deaths due to the occurrence of obstetric complications during labour and delivery. Little is known about the incidence and predictors of women’s place of delivery after utilizing antenatal care services in Ethiopia and the study area. Therefore, the purpose of this study is to fill those gaps in the studies mentioned above by determining the incidence and predictors of women’s place of delivery.

Methods

An institutional-based prospective cohort study was conducted among pregnant women in public hospitals of Gedeo zone, Southern Ethiopia between May 1 and October 30, 2021. A total of 390 pregnant women receiving antenatal care at Gedeo zone public hospitals were enrolled using a systematic random sampling technique and followed up to delivery. Data were entered into Epidata version 3.1 and exported to SPSS version 25 for analysis. For both bivariate and multivariable analyses, a poison regression model was used to identify the association between the dependent and independent variables. A statistical significance level was declared at a p-value less than 0.05.

Results

In this study, the overall incidence of home delivery and institutional delivery among pregnant women was 37.4% (95% CI: (32.5, 41.9)) and 62.6% (95% CI: 58.1, 67.5)) respectively. Distance from home to nearest health facility(ARR = 1.17:95%:CI (1.01,1.36), poor quality of antenatal care service(ARR = 1.40;95%:CI (1.10,1.79), no formal maternal education(ARR = 1.49;95%:CI (1.21,1.83), previous home delivery history(ARR = 1.38;95%:CI(1.22,1.56), unplanned pregnancy(ARR = 1.23;95%:CI (1.10,1.37) and history of pregnancy-related complication at health facility(ARR = 1.16;95%:CI(1.02,1.33) were predictors of home delivery.

Conclusions

The study indicated a high incidence of home birth after utilizing antenatal care services. As a result, interventions targeting those identified factors during antenatal care services are critical to reducing home births.

Keywords:

• Incidence
• place of delivery
• predictors
• antenatal care
• Ethiopia

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Transparency

Declaration of funding

This research was funded by the HEPI project with the supervision of Dilla University. The funders had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript.

Declaration of financial/other relationships

All authors state that they have no competing interests. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

TT, ZF, MA, and RG were involved in the designing, literature writing, conceptualization of the objectives and methodology, and statistical analysis of the result. AA, AS, DT, GA, EB, TG, DS, TM and MA were contributed to the design and development of the proposal, monitored data collection, assisted with analysis, and revised subsequent draft of the paper. The final manuscript was read and approved by all authors.

Acknowledgement

We would like to thank the data collectors, participants, and supervisors for their invaluable willingness and cooperation. We also want to thank Dilla University for facilitating the research project in with collaboration Health Professionals Education Partnership Initiative (HEPI- Ethiopia) - R25TW011214.

Data availability statement

Due to participant anonymity, the datasets generated and/or analyzed during this study are not publicly available, but they are available from the corresponding author upon reasonable request via email address ([email protected]).