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. 2025 May 23;5(3):100520.
doi: 10.1016/j.xagr.2025.100520. eCollection 2025 Aug.

Does obstetric violence influence institutional delivery utilization? Prevalence of fear of institutional delivery on subsequent pregnancy among mothers who gave birth in the past 12 months at Honkolo Wabe District, Arsi Zone Ethiopia, 2023

Solomon Seyife Alemu  1 , Getu Amsalu Erqu  2 , Dereje Diriba Woyessa  1 , Lema Fikadu Wedajo  3
Affiliations

Does obstetric violence influence institutional delivery utilization? Prevalence of fear of institutional delivery on subsequent pregnancy among mothers who gave birth in the past 12 months at Honkolo Wabe District, Arsi Zone Ethiopia, 2023

Solomon Seyife Alemu et al. AJOG Glob Rep. .

Abstract

Background: One of the issues that contribute to the increase in home births among mothers is the fear of giving birth in an institution. Although delivery services are free in Ethiopia, about half of women chose not to use them because they were afraid of giving birth in a hospital. Home deliveries are the leading cause of morbidity and mortality among mothers and newborns in Ethiopia. One of the major reasons why mothers choose not to give birth in medical facilities is due to fear of an institutional delivery. Nevertheless, no research has been conducted on Ethiopians' fear of institutional delivery.

Objective: This study aimed to assess the prevalence of fear of institutional delivery and associated factors among postnatal mothers.

Study design: Between May 1, 2023, and June 1, 2023, 423 postpartum mothers in Ethiopia's Honkolo Wabe district participated in a cross-sectional survey. A straightforward random sampling procedure was used to choose study participants. Data were gathered using a standardized questionnaire that was pretested and given by an interviewer in person. To find factors linked to the fear of institutional delivery, bivariate and multivariate analyses were performed. A P value of <.05 with a 95% confidence interval was designated as the level of statistical significance.

Results: The overall prevalence of fear of institutional delivery was 43.9% (95% confidence interval, 39.9%-48.2%). Obstetrical violence (adjusted odds ratio, 2.42 [95% confidence interval, 1.20-4.19]), number of children (adjusted odds ratio, 0.39 [95% confidence interval, 0.19-0.82]), poor knowledge on the importance of intuitional delivery (adjusted odds ratio, 2.20 [95% confidence interval, 1.39-3.49]), and a negative attitude toward skilled healthcare services (adjusted odds ratio, 2.13 [95% confidence interval, 1.15-3.94]) were significantly associated factors for fear of childbirth at health facilities.

Conclusion: Our study found that the prevalence of fear of institutional delivery is high. Therefore, healthcare providers, health extension workers, and other concerned bodies should work on increasing mothers' knowledge the importance of institutional delivery and their awareness of skilled birth. Similarly, respectful maternity care should be performed in accordance with attracting mothers to health institutions.

Keywords: Central Ethiopia; Honkolo Wabe; fear of institutional delivery; postnatal mothers.

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Figures

Figure
Figure
Fear of institutional delivery on subsequent pregnancy among postnatal mothers in the Honkolo Wabe woreda from May 1, 2023, to June 1, 2023
See this image and copyright information in PMC

References

    1. Namujju J., Muhindo R., Mselle L.T., Waiswa P., Nankumbi J., Muwanguzi P. Childbirth experiences and their derived meaning: a qualitative study among postnatal mothers in Mbale regional referral hospital, Uganda. Reprod Health. 2018;15:183. - PMC - PubMed
    1. Horsch A., Ayers S. In: Stress: concepts, cognition, emotion, and behavior. Fink G., editor. Elsevier; Amsterdam: 2016. Childbirth and stress; pp. 325–330.
    1. Wijma K., Wijma B., Zar M. Psychometric aspects of the W-DEQ; a new questionnaire for the measurement of fear of childbirth. J Psychosom Obstet Gynaecol. 1998;19:84–97. - PubMed
    1. Nasser S., Mansour S., Hassan N. Factors associated with fear of childbirth: it’s effect on women’s preference for elective cesarean section. J Nurs Educ Pract. 2016;7:133–146.
    1. Dencker A., Nilsson C., Begley C., et al. Causes and outcomes in studies of fear of childbirth: A systematic review. Women Birth. 2019;32:99–111. - PubMed

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