Abstract
Objectives This study examines the influence of women’s birth practices on their daughters’ location of childbirth in Ethiopia, investigating the importance of intergenerational patterns of care on contemporary birth practices. Methods A qualitative survey of women aged 60 and over in three cities in Ethiopia. Results Nearly all first generation women gave birth at home, but the majority of their daughters give birth in facilities. Perceptions of childbirth practices among both women and their daughters have shifted towards facility births, despite the prevalence of home birth in the previous generation. Conclusions Birth culture has experienced a profound shift in Ethiopia within one generation, especially in urban areas, where health facilities are more easily accessible. Older generations of women have positive attitudes towards facility birth, and can help influence their daughters to give birth with medical assistance. This aligns with both national and global maternal health policies which promote safe motherhood through facility birth.
Highlights
At 420 deaths per 100,000 live births, Ethiopia has one of the highest rates of maternal mortality in the world (WHO 2014)
Birth with a trained medical assistant, there is considerable evidence on the importance of family dynamics in determining birth location. This study illuminates these dynamics by presenting a historical context of intergenerational birth choices, analyzing the connection between a mother’s choice of birth location and her daughter’s
This is significant in helping chart the complex reasons for changing practices of childbirth in Ethiopia, a country with one of the highest maternal mortality rates in the world
Summary
At 420 deaths per 100,000 live births, Ethiopia has one of the highest rates of maternal mortality in the world (WHO 2014). To combat this high rate, the Ethiopian government has encouraged women to give birth in health facilities, where they can receive emergency medical assistance if necessary. Despite this policy, Ethiopia currently has one of the lowest rates of facility births in sub-Saharan Africa: by latest estimates, just 28% of births are attended by a trained professional.
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