BMC Pregnancy Childbirth. 2006 Aug 23;6:27. doi: 10.1186/1471-2393-6-27.
Home delivery and newborn care practices among urban women in western Nepal: a questionnaire survey.
BMC pregnancy and childbirth
Chandrashekhar T Sreeramareddy, Hari S Joshi, Binu V Sreekumaran, Sabitri Giri, Neena Chuni
PMID: 16928269
PMCID: PMC1560161 DOI: 10.1186/1471-2393-6-27
Abstract
BACKGROUND: About 98% of newborn deaths occur in developing countries, where most newborns deaths occur at home. In Nepal, approximately, 90% of deliveries take place at home. Information about reasons for delivering at home and newborn care practices in urban areas of Nepal is lacking and such information will be useful for policy makers.
METHODS: A cross-sectional survey was carried out in the immunisation clinics of Pokhara city, western Nepal during January and February, 2006. Two trained health workers administered a semi-structured questionnaire to the mothers who had delivered at home.
RESULTS: A total of 240 mothers were interviewed. Planned home deliveries were 140 (58.3%) and 100 (41.7%) were unplanned. Only 6.2% of deliveries had a skilled birth attendant present and 38 (15.8%) mothers gave birth alone. Only 46 (16.2%) women had used a clean home delivery kit and only 92 (38.3%) birth attendants had washed their hands. The umbilical cord was cut after expulsion of placenta in 154 (64.2%) deliveries and cord was cut using a new/boiled blade in 217 (90.4%) deliveries. Mustard oil was applied to the umbilical cord in 53 (22.1%) deliveries. Birth place was heated throughout the delivery in 88 (64.2%) deliveries. Only 100 (45.8%) newborns were wrapped within 10 minutes and 233 (97.1%) were wrapped within 30 minutes. Majority (93.8%) of the newborns were given a bath soon after birth. Mustard oil massage of the newborns was a common practice (144, 60%). Sixteen (10.8%) mothers did not feed colostrum to their babies. Prelacteal feeds were given to 37(15.2%) newborns. Initiation rates of breast-feeding were 57.9% within one hour and 85.4% within 24 hours. Main reasons cited for delivering at home were 'preference' (25.7%), 'ease and convenience' (21.4%) for planned deliveries while 'precipitate labor' (51%), 'lack of transportation' (18%) and 'lack of escort' during labor (11%) were cited for the unplanned ones.
CONCLUSION: High-risk home delivery and newborn care practices are common in urban population also. In-depth qualitative studies are needed to explore the reasons for delivering at home. Community-based interventions are required to improve the number of families engaging a skilled attendant and hygiene during delivery. The high-risk traditional newborn care practices like delayed wrapping, bathing, mustard oil massage, prelacteal feeding and discarding colostrum need to be addressed by culturally acceptable community-based health education programmes.
References
- Women Health. 2000;31(4):83-97 - PubMed
- Arch Dis Child Fetal Neonatal Ed. 1996 Jul;75(1):F42-5 - PubMed
- BMC Pregnancy Childbirth. 2004 May 22;4(1):8 - PubMed
- Int J Epidemiol. 1999 Dec;28(6):1172-5 - PubMed
- Acta Paediatr. 2002;91(5):546-54 - PubMed
- Soc Sci Med. 2005 Mar;60(5):911-21 - PubMed
- BMJ. 2002 Nov 9;325(7372):1063 - PubMed
- Lancet. 2006 Jan 28;367(9507):327-32 - PubMed
- J Health Popul Nutr. 2003 Dec;21(4):367-73 - PubMed
- Public Health Nutr. 2007 Feb;10(2):192-7 - PubMed
- Stud Fam Plann. 1995 Jan-Feb;26(1):22-32 - PubMed
- Indian Pediatr. 2001 Sep;38(9):952-65 - PubMed
- Health Policy Plan. 1998 Dec;13(4):371-83 - PubMed
- Midwifery. 2006 Mar;22(1):23-31 - PubMed
- Soc Sci Med. 2006 Jun;62(11):2798-809 - PubMed
- Soc Sci Med. 2000 Nov;51(10):1447-56 - PubMed
- Health Policy Plan. 1998 Jun;13(2):152-8 - PubMed
- Trop Med Int Health. 2006 Feb;11(2):228-37 - PubMed
- Hum Organ. 1983 Fall;42(3):235-46 - PubMed
- Indian Pediatr. 1989 Nov;26(11):1094-9 - PubMed
- J Trop Pediatr. 2005 Apr;51(2):82-6 - PubMed
- Kathmandu Univ Med J (KUMJ). 2006 Apr-Jun;4(2):258-63 - PubMed
Publication Types