Choice of place of maternity care among women in a semi urban population

Objectives: Persistent home birth among pregnant women is a significant public health concern in Nigeria. Increasing the proportion of births attended by skilled health personnel has been emphasized as a viable measure of progress for positive maternal and newborn outcomes worldwide. This study assessed the choice of place for antenatal care (ANC) and childbirth among women in a semi-urban population in southwestern Nigeria. Materials and Methods: The study employed a cross-sectional design. A sample of 168 pregnant women in the third trimester of pregnancy and who had had a minimum of one previous childbirth was selected through a multistage sampling method from all the administrative wards in two local government areas in a state in southwestern Nigeria. A structured and pretested questionnaire was used for data collection. Data were analyzed using Statistical Package for the Social Sciences software, version 25; descriptive statistics were presented in tables, and inferential statistics were analyzed at a level of significance of 0.05. Results: The results revealed that many of the respondents had skilled ANC (140, 83.3%) and skilled attendants at birth (120, 71.4 %) in their last pregnancy. A significant relationship was found between women’s choice of place of maternity care and trust in the traditional birth attendants (χ 2 = 7.714; P = 0.005), lack of transportation to the hospital (χ 2 = 42.0; P = 0.000), perception of birth at hospital as not necessary (χ 2 = 6.095; P = 0.014), flexible payment method for care in mission/spiritual home (χ 2 = 16.095; P = 0.000), and the actual cost of hospital birth (χ 2 = 24.381; P = 0.000). Husbands (114, 50%) were the major contributors to the women’s decisions in place of maternity care. Conclusion: The study concluded that most women utilized skilled care for pregnancy and childbirth, but not all the women who had ANC in the hospital utilized the hospital for childbirth as a result of personal and hospital-related factors. There is a need for health education intervention that can adequately inform and improve women’s self-efficacy to use skilled care in pregnancy and childbirth.