Attending home vs. clinic-based deliveries: Perspectives of skilled birth attendants in Matlab, Bangladesh

Blum, LS; Sharmin, T; Ronsmans, C; (2006) Attending home vs. clinic-based deliveries: Perspectives of skilled birth attendants in Matlab, Bangladesh. Reproductive health matters, 14 (27). pp. 51-60. ISSN 0968-8080 DOI:

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In an effort to make skilled attendance at birth more accessible, some countries in Asia have begun major initiatives to promote the option of home delivery with a midwife. Yet there is little empirical evidence from the region to suggest that home-based care is as safe or effective as core in medical facilities. Qualitative research involving key informant and in-depth interviews and group discussions was carried out in 2003 and 2004 in Matlab, a rural area of Bangladesh, to examine the feasibility of home- vs. facility-based delivery from the perspective of 13 skilled birth attendants. The findings illuminate major constraints encountered during home deliveries, including poor transportation, inappropriate environment for delivery, insufficient supplies and equipment, lack of security, and inadequate training and medical supervision, which may prevent the provision of skilled care. Most difficult was the pressure by families to adhere to traditional childbirth norms and convincing families to accept the need for referral. The advantages highlighted of attending births in a health facility were the safe, clean environment, availability of supplies, ability to accommodate other work activities and make quick referrals, and higher coverage. The study illuminates practical, cultural and medical issues that need to be taken into consideration when choosing between home- and facility-based strategies and designing safe motherhood interventions. (c) 2006 Reproductive Health Matters. All rights reserved.

Item Type: Article
Keywords: childbirth, safe motherhood, midwifery, qualitative research, Bangladesh, Rural bangladesh, maternity-care, program, mortality, Bangladesh, Cultural Characteristics, Female, Health Services Accessibility, organization & administration, Home Childbirth, Humans, Maternal Health Services, manpower, organization & administration, Medicine, Traditional, Midwifery, manpower, organization & administration, Pregnancy, Qualitative Research, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S., Rural Health
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Centre for Maternal, Reproductive and Child Health (MARCH)
Maternal Health Group
PubMed ID: 16713879
Web of Science ID: 237827600006


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