A strategy for reducing adverse pregnancy outcomes is the expanded implementation of maternity waiting homes (MWHs). MWH usage was associated with significantly improved childbirth outcomes.
Researchers assessed factors influencing MWH use, as well as the association between MWH stay and obstetric outcomes in a hospital in rural Ethiopia.
During the study period, 489 women gave birth at the hospital, 93 of whom were MWH users. Poisson regression with robust variance was conducted to estimate the relative risk (RR) of childbirth complications associated with MWH use vs. non-use. Five key informant interviews of a convenience sample of three MWH staff and two users were conducted and a thematic analysis performed of social, cultural, and economic factors underlying MWH use.
- Common reasons for using the MWH were post-term status, previous cesarean section/myomectomy, malposition/malpresentation, and low-lying placenta, placenta previa, or antepartum hemorrhage, and hypertension or preeclampsia.
- MWH users were more likely than non-users to have had a previous cesarean Sec. and to be post-term. MWH users were also more likely to undergo a cesarean Sec. and less likely to have a spontaneous vaginal delivery, obstructed labor, or stillbirth.
- MWH use was associated with a 77% lower risk of childbirth complications, a 94% lower risk of fetal and newborn complications, and a 73% lower risk of maternal complications compared to MWH non-users. Birth weight and 5-min Apgar scores were also higher in offspring of MWH users.
- Opportunity costs due to missed work and the need to arrange for the care of children at home, long travel times, and lack of entertainment were suggested as key barriers to MWH utilization.
To summarize, MWH usage was associated with significantly improved childbirth outcomes. Increasing facility quality, expanding services, and providing educational opportunities should be considered to increase MWH use.
BMC Pregnancy and Childbirth
Source: BMC Pregnancy and Childbirth