Nigerian women's reproductive aspirations in relation to their knowledge of the obstetric risks associated with grandmultiparity as seen at the University of Nigeria Teaching Hospital, Enugu, Nigeria

Abstract

Objective: To determine if Nigerian women's knowledge of the risks of grandmultiparity has any correlation with their reproductive aspirations.

Method: A structured interviewer-administered questionnaire survey of booked antenatal mothers seen over a 13-month period at the University of Nigeria Teaching Hospital, Enugu, Nigeria.

Results: One thousand, four hundred and thirteen (1413) women were interviewed from 1st July 2000 to 30th July 2001. Eighty-one (5.7% ) of the respondents felt that bearing 'too many' children was harmless while the remaining 1332 (94.5% ) felt it was harmful to their health. For these 1332 respondents, their definition of 'too many' ranged from 3 to 12 with a mean of 6.3 +/- 1.7. Over 60% of the 1332 respondents knew the common complications associated with grandmultiparity. Their mean desired family size was 5.0 +/- 1.4 (range: 3-10). At the beginning of their reproductive career, 38.9% of the respondents desired to be multiparous while the remaining 61.1% desired to be grandmultiparous. There was a significant positive correlation between the respondents' definitions of grandmultiparity and their desired family sizes (r = 0.5, p = 0.000). The respondents were categorized into: (a) those likely to become grandmultiparous,based on a desired family size = 5 and (b) those unlikely to, based on a desired family size < 5. Twelve of 33 variables tested as predictors of grandmultiparity were statistically significant on univariate logistic regression (p = 0.05). Apart from the respondents' definition of grandmultiparity, most of the other significant variables were socio-cultural factors; e.g., lack of post-secondary education (OR = 2.0); need to compensate for the small size of husband's family (OR = 2.3) and need for children who will take care of the respondents in old age (OR = 1.8). Knowledge of the specific obstetric risks associated with grandmultiparity was one of the 21 variables that were not statistically significant. On multivariate logistic regression, the respondents' definition of grandmultiparity was the only significant predictor of grandmultiparity (B = 0.6, OR = 1.8, p = 0.003).

Conclusion: The higher the number of pregnancies a Nigerian woman perceives as being harmful, the more likely is she to become grandmultiparous. However,. there is no significant correlation between her knowledge of specific obstetric risks associated with grandmultiparity and her likelihood of becoming grandmultiparous. The implications of the results are discussed.