reasons rural laotians choose home deliveries over delivery at health facilities a qualitative study原因农村老挝人选择送货上门的服务交付在医疗机构定性研究.pdfVIP

Sychareun et al. BMC Pregnancy and Childbirth 2012, 12:86 /1471-2393/12/86 RESEARCH ARTICLE Open Access Reasons rural Laotians choose home deliveries over delivery at health facilities: a qualitative study 1,3* 1 1 1 Vanphanom Sychareun , Visanou Hansana , Vatsana Somphet , Sisouvanh Xayavong , Alongkone Phengsavanh1 and Rebecca Popenoe2 Abstract Background: Maternal mortality among poor rural women in the Lao People’s Democratic Republic (Lao PDR) is among the highest in Southeast Asia, in part because only 15% give birth at health facilities. This study explored why women and their families prefer home deliveries to deliveries at health facilities. Methods: A qualitative study was conducted from December 2008 to February 2009 in two provinces of Lao PDR. Data was collected through eight focus group discussions (FGD) as well as through in-depth interviews with 12 mothers who delivered at home during the last year, eight husbands and eight grandmothers, involving a total of 71 respondents. Content analysis was used to analyze the FGD and interview transcripts. Results: Obstacles to giving birth at health facilities included: (1) Distance to the health facilities and difficulties and costs of getting there; (2) Attitudes, quality of care, and care practices at the health facilities, including a horizontal birth position, episiotomies, lack of privacy, and the presence of male staff; (3) The wish to have family members nearby and the need for women to be close to their other children and the housework; and (4) The wish to follow traditional birth practices such as giving birth in a squatting position and lying on a “hot bed” after delivery. The decision about where to give birth was commonly made by the wo