Factors contributing to home births among postpartum women in Manzini, Swaziland

Abstract

Background/Aims Home births carry risks, especially in underdeveloped areas, including labour and childbirth complications and maternal and perinatal morbidity and mortality. Intrapartum care offered in healthcare facilities has fewer risks, as they employ skilled birth attendants and medical equipment. However, widespread provision of intrapartum care remains challenging in Swaziland. The incidence of avoidable intrapartum maternal and perinatal challenges could be reduced if more women gave birth accompanied by skilled birth attendants. The aim of this study was to explore and describe the factors associated with home birth in Swaziland, despite the practice being discouraged. Methods A qualitative design using convenient sampling was used. A total of 13 postpartum women took part in the study, who gave birth at home and brought their newborn babies to a well-baby clinic for immunisation 3 days after birth. Individual in-depth interviews were conducted and the data were subjected to thematic analysis. One theme was identified with associated subthemes. Results Personal factors formed the main theme describing the reasons for home birth. The subthemes were ignorance, silent labour, financial problems and access to a traditional birth attendant. Conclusions Enhanced health education during antenatal care on labour signs as well as reduced or abolished hospital fees for pregnant women and improved availability of ambulance services may help address women's reasons for choosing home birth. Encouraging women to give birth with a skilled birth attendant is important to reduce maternal and neonatal morbidity and mortality.