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Are Women Deciding against Home Births in Low and Middle Income Countries?

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  • Fiifi Amoako Johnson
  • Sabu S Padmadas
  • Zoë Matthews

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.

Suggested Citation

  • Fiifi Amoako Johnson & Sabu S Padmadas & Zoë Matthews, 2013. "Are Women Deciding against Home Births in Low and Middle Income Countries?," PLOS ONE, Public Library of Science, vol. 8(6), pages 1-10, June.
  • Handle: RePEc:plo:pone00:0065527
    DOI: 10.1371/journal.pone.0065527
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    2. Paul, Bimal Kanti & Rumsey, Deborah J., 2002. "Utilization of health facilities and trained birth attendants for childbirth in rural Bangladesh: an empirical study," Social Science & Medicine, Elsevier, vol. 54(12), pages 1755-1765, June.
    3. Deon Filmer & Lant Pritchett, 2001. "Estimating Wealth Effects Without Expenditure Data—Or Tears: An Application To Educational Enrollments In States Of India," Demography, Springer;Population Association of America (PAA), vol. 38(1), pages 115-132, February.
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