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The effect of prenatal and intrapartum care on the stillbirth rate among women in rural Ethiopia
Author(s) -
Ballard Karen,
Belete Zelalem,
Kinfu Hirut,
Tadesse Mebkyou,
Amin Mohammed,
Atnafu Habtamu
Publication year - 2016
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2015.09.027
Subject(s) - medicine , childbirth , prenatal care , odds ratio , obstetrics , pregnancy , health facility , confidence interval , health care , family medicine , environmental health , population , health services , genetics , pathology , economic growth , economics , biology
Objective To determine whether community‐based prenatal and intrapartum care in Ethiopia results in a lower stillbirth rate. Methods Between May and December 2014, a randomly selected sample of women in northern and eastern Ethiopia who had delivered a neonate in the preceding 12 months completed a face‐to‐face survey about their experiences of maternal services and the fetal outcome for each delivery. The stillbirth rates among women delivering at home and at health facilities were compared. Results Overall, 4442 women completed surveys. Stillbirth was reported by 42 (1.7%) of the 2437 women who had received prenatal care and 53 (2.8%) of the 1921 women who did not receive prenatal care ( P = 0.01). The stillbirth rate was similar among women who delivered in a health center (27/1417 [1.9%]), in a hospital (6/126 [4.8%]), and at home (62/2725 [2.3%]; P = 0.13). However, women experiencing an intrapartum emergency were twice as likely to deliver in a health facility (odds ratio 2.6, 95% confidence interval 2.2–3.0). Satisfaction with health‐center care was moderately good (median score 77.5/100). Conclusion The stillbirth rate was reduced among women receiving prenatal care, although delivering in a health facility did not reduce the risk of stillbirth. Improving the quality of health‐center care could lead to their planned use for childbirth, which might reduce stillbirth rates.