Ekele Bissallah A, Tunau Karima A
Department of Obstetrics and Gynecology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.
Acta Obstet Gynecol Scand. 2007;86(5):627-30. doi: 10.1080/00016340601134622.
The utilization of antenatal care services does not necessarily equate to delivery at the health facility. The objectives of this study were to determine the proportion of pregnant women who had antenatal care and delivered in the hospital and the reasons for delivery elsewhere.
Pregnant women of low risk who initiated antenatal care at the University Teaching Hospital were recruited consecutively from January to June 2004 and longitudinally followed up until delivery. A two-part questionnaire was used to obtain information on biosocial data, place of delivery, accoucher, fetomaternal outcome, and reason(s) for delivery elsewhere.
Of the 1,080 women studied, 740 (68.5%) delivered in the hospital while 340 (31.5%) delivered elsewhere. The majority (52) of the deliveries elsewhere were at the woman's home. There were more literate women amongst the hospital delivery group, while there were more women of high parity and with a previous home birth in the home delivery group (p<0.05). Fetomaternal outcomes were similar in both groups. Nurses/midwives conducted most (60%) of the home deliveries and the principal reasons for home births were privacy and lack of transport during labor.
68.5% of women who had uneventful antenatal care delivered in the hospital. Home delivery was the commonest site for delivery elsewhere and the main reasons were privacy and lack of transportation. Skilled attendants conducted most of the home deliveries with good fetomaternal outcome. There might be a need to encourage women during antenatal care to reach out for skilled attendants when home delivery becomes inevitable.
产前保健服务的利用并不一定等同于在医疗机构分娩。本研究的目的是确定接受产前保健并在医院分娩的孕妇比例以及在其他地方分娩的原因。
2004年1月至6月，连续招募在大学教学医院开始产前保健的低风险孕妇，并对其进行纵向随访直至分娩。使用两部分问卷获取有关生物社会数据、分娩地点、接生人员、母婴结局以及在其他地方分娩的原因等信息。
在研究的1080名妇女中，740名（68.5%）在医院分娩，而340名（31.5%）在其他地方分娩。在其他地方分娩的大多数（52名）是在家中。医院分娩组中识字的妇女更多，而在家中分娩组中多产且有过在家分娩经历的妇女更多（p<0.05）。两组的母婴结局相似。大多数（60%）的家庭分娩由护士/助产士进行，在家中分娩的主要原因是隐私和分娩时缺乏交通工具。
接受了正常产前保健的妇女中有68.5%在医院分娩。在家中分娩是在其他地方分娩最常见的地点，主要原因是隐私和缺乏交通工具。大多数家庭分娩由熟练的医护人员进行，母婴结局良好。当不可避免要在家中分娩时，可能需要在产前保健期间鼓励妇女寻求熟练的医护人员帮助。
