Machakos project studies. Agents affecting health of mother and child in a rural area of Kenya. XXI. Antenatal and delivery care.

Traditional and modern antenatal and delivery care is described for women who delivered during 1975 and 1976 and who belonged to the study population of the Machakos project studies. During their pregnancy 84% of the women had visited at least once an antenatal clinic. When asked during pregnancy 56% of the women stated that they intended to deliver in hospital but only 26% ultimately did so. Hospital delivery seemed to depend mostly on opportunity and habit. Of the special risk factors for complications of pregnancy and delivery only previous caesarean section and low height, and to a lesser degree primiparity, operated in favour of hospitalisation. Abdominal massage, given by traditional midwives, was the main form of traditional antenatal care; it was used mainly for abdominal pain. There was little interference during labour of deliveries attended by traditional midwives and few harmful practices were discovered. Their factual knowledge and understanding of anatomy and physiology of pregnancy and delivery was limited. Suggestions are given on how to promote hospital delivery among those women who require this for medical reasons.