Perceptions, Practices and Challenges on Birth Planning in Rural Bangladesh

Animesh Biswas; Abu Sayeed Md. Abdullah

doi:7180238

Background: Birth planning is essential to ensure safe delivery of mother. Inadequate birth planning during pregnancy increases risk of maternal and neonatal deaths including stillbirths. Bangladesh is facing challenge to address appropriate birth planning for pregnant mothers. Objective: The study explores the perception and practice of birth planning among the rural communities. Moreover, the study reveals the challenges in the community related to birth planning issues. Methods: A qualitative study has been conducted in a district of Bangladesh. Five focus group discussions (FGDs) and twenty in-depth interviews (IDIs) were conducted in the rural community. Results: The study found that mother’ perceptions are highly important, which are scarce in practice. Ignorance, traditional myth and perception of a male person in the family, influences of traditional birth attendants and villages doctors have been identified as the main barriers of an appropriate birth plan. Conclusions: The study concludes that community perception of birth planning is inadequate and the decision makers in the family are irresponsible to take appropriate planning for the mothers. Barriers in the society also influence, thus, to ensure safe delivery and to reduce the maternal and neonatal deaths in Bangladesh. Policy makers need to emphasise on the specific community needs on birth planning.

[1]

World Health Organization (WHO). Trends in Maternal Mortality: 1990 to 2008 Estimates developed by WHO, UNICEF, UNFPA and The World Bank. 2010.

[2]

Zahr CA and.Tessa W. Ante-natal care in developing countries: promises, achievements and missed opportunities: an analysis of trends, levels and differentials. World Heal. Organ. 2003.

[3]

Arifeen SEI, Hill K, Ahsan KZ, Jamil K, Nahar Q, Streatfield PK. Maternal mortality in Bangladesh: a Countdown to 2015 country case study. Lancet. 2014; 384 (9951): 1366–74.

[4]

Anwar I, Kalim N, Koblinsky M. Quality of obstetric care in public-sector facilities and constraints to implementing emergency obstetric care services: evidence from high- and low-performing districts of Bangladesh.J. Health. Popul. Nutr. 2009; 27 (2): 139–55.

[5]

Koblinsky M, Anwar I, Mridha MK, Chowdhury ME, Botlero R. Reducing maternal mortality and improving maternal health: Bangladesh and MDG 5. J. Heal. Popul. Nutr. 2008; 26 (3): 280–94.

[6]

Preconception and Prenatal Care for Women. [Internet]. 2015 October. Available from: http://www.uniteforsight.org/women-children-course/preconception-prenatal-women

[7]

Laishram J, Thounaojam UD, Panmei J, Mukhia S, Devi HS. Knowledge and Practice of Ante-natal Care in an Urban Area. Indian Medical Gazette. 2013;101–6.

[8]

McKelden S.Your Birth Plan: Things To Consider. Tips on making important pre-baby choices. [Internet]. 2015 October. Available from: http://www.babble.com/pregnancy/birth-plan-considerations/.

[9]

National Collaborating Centre for Women’s and Children's Health and National Collaborating Centre for Women’s and Children’s Health. Pregnancy and Complex Social Factors: A Model for Service Provision for Women with Complex Social Factors. 2010; 110(1): 316.

[10]

Lewis G. The Confidential Enquiry into Maternal and Child Health (CEMACH). Saving Mothers’ Lives: reviewing maternal deaths to make motherhood safer 2003–2005, The Seventh Report on Confidential Enquiries into Maternal Deaths in the United Kingdom. Obstet Med. 2008; 1(54): 1–27.

[11]

Singha R. Target of MDG To Development of Maternal Health in Bangladesh: a Review of BRAC Achievement. Bangladesh Res. Pub. J. 2012; 7(4): 454–60.

[12]

National Institute of Population Research and Training (NIPORT), USAID, UN Population Fund, AusAID, Measure Evaluation, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b). Bangladesh maternal mortality and health care survey 2010. Dhaka: NIPORT, Measure Evaluation, icddr, b, 2011.

[13]

National Institute of Population Research and Training (NIPORT), Mitra and Associates and II. Bangladesh Demographic and Health Survey: Key Indicators 2014. Dhaka; 2014.

[14]

NIPORT, ORC Macro, Johns Hopkins University, icddr b. Bangladesh maternal health services and maternal mortality survey 2001. Dhaka and Calverton: NIPORT, ORC Macro, Johns Hopkins University, icddr, b, 2003.

[15]

Barkat A, Majid M, Mahiyuddin G, Poddar A, Rahman M. Survey on Current Status of Maternal and Neonatal Health Initiatives in Bangladesh. Ministry of Health and Family Welfare (MOHFW). 2013. [Internet]. 2015 October. Available from: http://www.hdrcbd.com/admin_panel/images/notice/1386584915.report%20on%20current%20status%20of%20mnh%20initiative%20in%20bangladesh.pdf

[16]

Khan R, Blum LS, Shelly SB, Sultana M, Nahar Q, Streatfield PK. Exploring Birth Planning and Responses to Delivery Complications: A Qualitative investigation to supplement the Bangladesh Maternal Mortality and Health Care Survey 2010, MEASURE Evaluation and icddr,b. 2014; 123(55): 978–84.

[17]

Irving S. Interviewing as Qualitative Research - A Guide for Researchers in Education and the Social Sciences. Teachers College, Columbia University. USA. 2006.

[18]

Boyatzis RE. Transforming qualitative information: Thematic analysis and code development. Sage. 1998.

[19]

Kaso M, Addisse M. Birth preparedness and complication readiness in Robe Woreda, Arsi Zone, Oromia Region, Central Ethiopia: a cross-sectional study. Reprod. Health. 2014; 11 (1): 55.

[20]

Department of Health. Maternity Matters: Choice, access and continuity of care in a safe service. London 2007. [Internet]. 2015 October. Available from: http://webarchive.nationalarchives.gov.uk/20130107105354/http:/www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_074199.pdf, 2007.

[21]

Confidential Enquiry into Maternal and Child Health (CEMACH), “Perinatal Mortality 2007 June 2009 London: CEMACH,” in http://www.hqip.org.uk/assets/NCAPOP-Library/CMACE-Reports/37.-June-2009-Perinatal-Mortality-2007.pdf, 2009, no. June, pp. 1–88.

[22]

Doering SG, Entwisle DR. Preparation during pregnancy and ability to cope with labor and delivery. Am. J. Orthopsychiatry. 1975; 45 (5): 825–37.

[23]

Aktar S. Health Care Seeking Behavior for Safe Motherhood: Findings from Rural Bangladesh. Bangladesh e-Journal of sociology. 2012; 9 (2): 57–70.

[24]

Rahman M, Islam R, Islam AZ. Rural-Urban Differentials of Utilization of Ante-Natal Health-Care Services in Bangladesh. Health policy and development. 2008; 6 (3): 117–25.

[25]

Chowdhury S, Hossain SA, Halim A. Assessment of quality of care in maternal and newborn health services available in public health care facilities in Bangladesh. Bangladesh Med. Res. Counc. Bull. 2009; 35 (2): 53–56.

[26]

Chowdhury HA, Akter J, Afroz A, Rahman MM, Hafez MA. Factors associated with use of antenatal care services in a rural area of Bangladesh. South East Asia Journal of public Health. 2012; 2 (2): 61–66.

[27]

Koenig MA, Jamil K, Streatfield PK, Saha T, Al-Sabir A, Arifeen SEl, Hill K, Haque Y. Maternal health and care-seeking behavior in Bangladesh: findings from a national survey. Int. Fam. Plan. Perspect. 2007; 33: 75–82.

[28]

Fauveau V, Stewart K, Khan SA, Chakraborty J. Effect on mortality of community-based maternity-care programme in rural Bangladesh.. Lancet. 1991; 338 (8776): 1183–86.

[29]

Ronsmans C, Chowdhury ME, Koblinsky M, Ahmed A. Care seeking at time of childbirth, and maternal and perinatal mortality in Matlab, Bangladesh.. Bull. World Health Organ. 2010; 88 ( 4): 289–96.