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      How Baloch Women Make Decisions About the Risks Associated With Different Childbirth Settings in Southeast Iran

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          Abstract

          Background:

          In Zahedan City in Southeast Iran, some women prefer to give birth at home despite the availability of the equipped hospitals and expert advice that hospital births are safer.

          Objectives:

          This study explains how Baloch women make decisions regarding the risks associated with childbirth at home versus a hospital. This study identifies and defines the factors that influence the choice of the place of delivery by Baloch women.

          Materials and Methods:

          The article draws on data from a grounded theory. In particular, on in-depth interviews with 25 Baloch women, 21 of whom had planned home births and 4 planned hospital births in their most recent childbirth.

          Results:

          Six categories emerged from the data as follows: 1) deliberation and risk assessment; 2) obstacles to hospital births; 3) preference for hospital births; 4) obstacles to homebirth; 5) preference for homebirth; and 6) risk management. The core category was deliberation and risk assessment. Our interviews showed that Baloch woman weighed the negative and positive aspects of each option when deciding on a childbirth setting. In this process, their assessment of risk included physical wellbeing and sociao-cultural values. Furthermore, their assessment of risk can, in some circumstances, result in delays or avoidance of having hospital childbirth.

          Conclusions:

          Managers and service providers need to know an ordinary woman’s perception of risk to address the gap between current and desired childbirth services and encourage women to use current hospital services.

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          Most cited references 43

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          Utilization of maternal health care services in Southern India.

          This paper examines the patterns and determinants of maternal health care utilization across different social settings in South India: in the states of Andhra Pradesh, Karnataka, Kerala and Tamil Nadu. Data from the National Family Health Survey (NFHS) carried out during 1992-93 across most states in India are used. Results show that utilization of maternal health care services is highest in Kerala followed by Tamil Nadu, Andhra Pradesh and Karnataka. Utilization of maternal health care services is not only associated with a range of reproductive, socio-economic, cultural and program factors but also with state and type of health service. The interstate differences in utilization could be partly due to variations in the implementation of maternal health care program as well as differences in availability and accessibility between the states. In the case of antenatal care, there was no significant rural-urban gap, thanks to the role played by the multipurpose health workers posted in the rural areas to provide maternal health care services. The findings of this study provide insights for planning and implementing appropriate maternal health service delivery programs in order to improve the health and well-being of both mother and child.
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            Analyzing Qualitative Data

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              Utilization of care during pregnancy in rural Guatemala: does obstetrical need matter?

              This study examines factors associated with the use of biomedical care during pregnancy in Guatemala, focusing on the extent to which complications in an ongoing or previous pregnancy affect a woman's decisions to seek care. The findings, based on multilevel models, suggest that obstetrical need, as well as demographic, social, and cultural factors, are important predictors of pregnancy care. In contrast, measures of availability and access to health services have modest effects. The results also suggest the importance of unobserved variables--such as quality of care--in explaining women's decisions about pregnancy care. These results imply that improving proximity to biomedical services is unlikely to have a dramatic impact on utilization in the absence of additional changes that improve the quality of care or reduce barriers to access. Moreover, current efforts aimed at incorporating midwives into the formal health-care system may need to extend their focus beyond the modification of midwife practices to consider the provision of culturally appropriate, high-quality services by traditional and biomedical providers alike.
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                Author and article information

                Journal
                Nurs Midwifery Stud
                Nurs Midwifery Stud
                Kashan University of Medical Sciences
                Nursing and Midwifery Studies
                Kashan University of Medical Sciences
                2322-1488
                2322-1674
                20 March 2015
                March 2015
                : 4
                : 1
                Affiliations
                [1 ]Faculty of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, IR Iran
                [2 ]Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
                [3 ]Department of Demography and Population Studies, Faculty of Social Science, University of Tehran, Tehran, IR Iran
                Author notes
                [* ]Corresponding author: Zahra Moudi, Faculty of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, IR Iran. Tel: +98-9153411005, Fax: +98-5433442481, E-mail: zz_moudi@ 123456yahoo.com
                Article
                4377531
                4f8bd315-5b4a-4bd2-a7bd-3be5ce514a2f
                Copyright © 2015, Kashan University of Medical Sciences.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

                Categories
                Research Article

                risk assessment, risk management, child, decision making, iran

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