Factors determining place of delivery of pregnant woman: A cross-sectional study conducted in Western part of Gujarat

Background: Institutional delivery with appropriate delivery care is one of the key paths toward achieving maternal mortality ratio target of sustainable developmental goals-3. Delay in receiving timely and adequate care at health facility is deciding factor in reducing maternal mortality. Importance of closeness of health facility, cost at private hospitals, spiritual factors, social factors, etc., play a crucial role in deciding place of delivery. Important indicator of Reproductive, Maternal, Newborn Child plus Adolescent Health programme for antenatal care (ANC) is early registration of pregnancy, minimum three (upgraded to four) antenatal checkups, proportion of delivery conducted by skilled birth attendant, etc. Various demographic factors and ANC factors play a crucial role in selection of place of delivery. Objectives: The objectives of this study were to examine the demographic factors and ANC in determining place of delivery. Materials and Methods: This community-based cross-sectional retrospective study was conducted in eight Primary Health Centre areas of Jamnagar district of Gujarat during September 2015–August 2016. Multistage sampling was used and convenient samples of a total of 400 mothers who delivered during the past 6 months were taken as study participants. Chi-square test and Fisher’s exact test were used for analysis. Results: Among the study participant mothers, 384 (96%) had institutional delivery while 16 (4%) mothers were delivered at home. Statistically significant difference in place of deliveries was found among caste (P < 0.05), among different socioeconomic classes (P < 0.01), and among different education level of mothers (P < 0.01). Among 16 home deliveries, 10 (62.5%) were neither registered during antenatal period nor received Mamta Card. Conclusion: Increasing education level of females, 100% ANC registration, and minimum four ANC checkups are the key steps toward 100% institutional deliveries.