Socioeconomic barriers to safe motherhood among booked patients in rural Nigerian communities

Abstract

This study examines the socioeconomic barriers to safe motherhood in booked patients in the Ife-Ijesha health administrative zone, Nigeria. During the period of study (January 1998 to December 1998), 161 booked patients of Ife State Hospital, Ile-Ife and Wesley Guild Hospital, Ilesha presented with an avoidable obstetric emergency, Seventeen (10.6%) presented during the antenatal period, while 89 (55.3%) and 55 (34.2%) presented in labour and postpartum respectively. The patients presented with obstetric complications such as obstructed labour (24.2%), postpartum haemorrhage (21.1%), puerperal sepsis (24.2%), imminent eclampsia and eclampsia (15.5%), retained second twin (9.3%). Three maternal deaths occurred (MMR 1467/100 000 births) and the perinatal mortality rate was 290/1000 total births. The adduced reasons for late presentation included, financial constrains (85.1%), poor access to hospital/transportation difficulties (33.5%), objection to hospital admission by relatives (23.0%), aversion to caesarean section (21.7%) and attitude to hospital staff (8.1%). The patients were of the opinion that reducing the economic burden associated with hospital fee, provision of transportation, encouraged family support and reduction of operation rate would lead to reduction in late presentation.