scholarly journals Maternal Autonomy and High-Risk Pregnancy in Bangladesh: The Mediating Influences of Childbearing Practices and Antenatal Care

2020 ◽  
Author(s):  
Sumaiya Abedin ◽  
Dharma Arunachalam

Abstract Background: Maternal, infant and neonatal mortality rates are high in Bangladesh. Certain childbearing practices and poor utilisation of antenatal care services make Bangladeshi women more vulnerable to experience poor health during pregnancy and adverse pregnancy outcomes. Also, women in Bangladesh remain considerably subordinate to men in almost all aspects of their lives, from education and work opportunities to healthcare utilisation. This study investigates the severity of health complications during pregnancy in relation to women’s autonomy, and how childbearing practices and utilisation of antenatal care mediate this relationship. Methods: Data from the most recent Bangladesh Demographic and Health Survey (BDHS) is used in this study. Multinomial regression models (MLRM) are employed to examine the relationship between the outcome variable - high risk pregnancy, and explanatory variables - women’s autonomy, childbearing practices and use of antenatal care. Results: In Bangladesh, about 41.5% of women experienced high-risk pregnancies involving multiple health complications. Findings showed that women’s autonomy in decision-making, freedom of movement and economic autonomy were significantly associated with high-risk pregnancies. However, women’s autonomy in physical mobility in particular did so only through the mediating factors of maternal childbearing practices and antenatal care. Specifically, both early and delayed childbearing and shorter birth interval increased the likelihood of high-risk (multiple complications) pregnancies by about 30% and 31% respectively, high parity increased the risk by 23% and use of antenatal care decreased it by 46%. Conclusion: The Women’s decision-making autonomy, freedom of movement and economic autonomy had significant effects on high-risk pregnancies. However, the effects were mediated by both maternal childbearing practices and use of antenatal care in a limited way. Policies and programmes aimed at improving pregnancy outcomes need to focus on all three sets of factors: women’s autonomy, childbearing practices and use of antenatal care.

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sumaiya Abedin ◽  
Dharma Arunachalam

Abstract Background Maternal, infant and neonatal mortality rates are high in Bangladesh. Certain childbearing practices and poor utilisation of antenatal care services make Bangladeshi women more vulnerable to experience poor health during pregnancy and adverse pregnancy outcomes. Also, women in Bangladesh remain considerably subordinate to men in almost all aspects of their lives, from education and work opportunities to healthcare utilisation. This study investigates the severity of health complications during pregnancy in relation to women’s autonomy, and how childbearing practices and utilisation of antenatal care mediate this relationship. Methods Data from the most recent Bangladesh Demographic and Health Survey (BDHS) is used in this study. Multinomial regression models (MLRM) are employed to examine the relationship between the outcome variable - high risk pregnancy, and explanatory variables - women’s autonomy, childbearing practices and use of antenatal care. Results In Bangladesh, about 41.5% of women experienced high-risk pregnancies involving multiple health complications. Findings showed that women’s autonomy in decision-making, freedom of movement and economic autonomy were significantly associated with high-risk pregnancies. However, women’s autonomy in physical mobility in particular did so only through the mediating factors of maternal childbearing practices and antenatal care. Specifically, both early and delayed childbearing and shorter birth interval increased the likelihood of high-risk (multiple complications) pregnancies by about 30% and 31% respectively, high parity increased the risk by 23% and use of antenatal care decreased it by 46%. Conclusions The Women’s decision-making autonomy, freedom of movement and economic autonomy had significant effects on high-risk pregnancies. However, the effects were mediated by both maternal childbearing practices and use of antenatal care in a limited way. Policies and programmes aimed at improving pregnancy outcomes need to focus on all three sets of factors: women’s autonomy, childbearing practices and use of antenatal care.


2020 ◽  
Author(s):  
Sumaiya Abedin ◽  
Dharma Arunachalam

Abstract Background Maternal, infant and neonatal mortality rates are high in Bangladesh. Certain childbearing practices and poor utilisation of antenatal care services make Bangladeshi women more vulnerable to experience poor health during pregnancy and adverse pregnancy outcomes. Also, women in Bangladesh remain considerably subordinate to men in almost all aspects of their lives, from education and work opportunities to healthcare utilisation. This study investigates the severity of health complications during pregnancy in relation to women’s autonomy, and how childbearing practices and utilisation of antenatal care mediate this relationship. Methods Data from the most recent Bangladesh Demographic and Health Survey (BDHS) is used in this study. Multinomial regression models (MLRM) are employed to examine the relationship between the outcome variable - high risk pregnancy, and explanatory variables - women’s autonomy, childbearing practices and use of antenatal care. Results In Bangladesh, about 41.5% of women experienced high-risk pregnancies involving multiple health complications. Findings showed that women’s autonomy in decision-making, freedom of movement and economic autonomy were significantly associated with high-risk pregnancies. However, women’s autonomy in physical mobility in particular did so only through the mediating factors of maternal childbearing practices and antenatal care. Specifically, both early and delayed childbearing and shorter birth interval increased the likelihood of high-risk (multiple complications) pregnancies by about 30% and 31% respectively, high parity increased the risk by 23% and use of antenatal care decreased it by 46%.Conclusion The Women’s decision-making autonomy, freedom of movement and economic autonomy had significant effects on high-risk pregnancies. However, the effects were mediated by both maternal childbearing practices and use of antenatal care in a limited way. Policies and programmes aimed at improving pregnancy outcomes need to focus on all three sets of factors: women’s autonomy, childbearing practices and use of antenatal care.


2019 ◽  
Author(s):  
Sumaiya Abedin ◽  
Dharma Arunachalam

Abstract Background A high level of maternal, infant and neonatal mortality occurs in Bangladesh. Certain childbearing practices as well as low use of antenatal care services make Bangladeshi women more vulnerable to experience poor health during pregnancy which contributes adverse birth outcomes. Also, women in Bangladesh remain considerably subordinate to men in almost all aspects of their lives, from education and work opportunities to healthcare utilisation. This lack of opportunities contributes to the low status of women within their family and society, and generally poor health outcomes for both mother and children. This study thus aims to investigate the factors associated with severity of health complications during pregnancy in relation to the low status of women, and the relative role of childbearing practices and antenatal care uptake to influence this relationship. Methods The relevant data from the last Bangladesh Demographic and Health Survey (BDHS) is used in this study. Multinomial logistic regression models (MLRM) of categorical response variables are applied as statistical tools to analyse the relevant data for the outcome variable: high-risk pregnancy. Results In Bangladesh, about 38.7% of women experienced high-risk pregnancies with multiple health complications. Findings of the study firstly found women’s decision-making autonomy and freedom of movement significantly associated with high-risk pregnancies. However, the results further reveal that maternal childbearing practices and antenatal care uptake had strong significant effects on high-risk pregnancies. Maternal age, particularly early childbearing of women had about 52% increased risk, and use of antenatal care had about 0.58 times less risk in having high-risk pregnancies. Conclusion Although the maternal decision-making autonomy and freedom of movement had significant effects on high-risk pregnancies, however, their relationships were strongly mediated by both maternal childbearing practices and uses of antenatal care.


2014 ◽  
Vol 6 (3) ◽  
Author(s):  
Dian Ekowati ◽  
Ekawati Sri ◽  
Said Rusli

Fertility is often seen on the figures and biological sides. Seeing fertility goes beyond both of these will be <br />useful to explore the wishes of each actor , how they relate to each other and to the community , and how the values and aspects of sociological and psychological that is attached in such activities. The study explored how the relationship between gender relations and fertility work ; especially because until now there is no generic theory agreed to this issue . This study used qualitative methods to explore and gain an understanding of how women give birth as related parties with the other actors . The framework of this study were made by utilizing research - research that has been done before , namely the concept of female autonomy ( Mason and Smith , 2003) and the concept of the determinant ( Bongaarts , 1978) . The concept is referred to aspects of women's autonomy is the power of women to make household economic decisions , the power of women to make decisions about family size , women freedom of movement , individual attitudes toward gender attitude of the community , and the movement of women in decision-making ( Mason and Smith , 2003 . Determinants required for connecting between socio - economic variables - culture with fertility because after all , there are facts that can not be denied that fertility is the result of biological activity . The results showed that although the values at the community level suggested to have the number of children that a lot , to a certain extent , the women in the study area can control the number of children they have. This control works through Desired fertility and the determinants , namely : the use of contraception and delay the age of marriage is influenced by women's autonomy and power as proposed by Mason and Smith ( 2003) . Women's autonomy and power in question is the power of women in economic decision-making , decision-making power of women in family size , their physical freedom of movement , the size of the gender attitudes at the community level , and their space in household decisionmaking . The conclusion of this study indicate that in the study area , the use of contraception is more influential in affecting fertility than the actual delay marriage age. <br /> Keywords : Gender Relationships, Fertility, Aspects of Women's Autonomy and Power , Desired Fertility, Actual Fertility, Reuters Determinants  <br />


2019 ◽  
Vol 4 (1) ◽  
pp. 199
Author(s):  
Rosmeri Bukit

<p><em>A high-risk pregnancy is a pathological pregnancy that can affect the general state of the mother and baby. Early detection can be done on antenatal care service is by increasing coverage of antenatal care especially pregnancy examination ≥ 4 times or K4. The purpose of this study is to determine the relationship of pregnancy examination K4 with high risk of third trimester pregnancy at Harapan Raya Pekanbaru Health Center in 2014. The research quantitative type with analytical method, using cross sectional approach. Population of all pregnant women in the third trimester who conducted pregnancy checkup at the Puskesmas Harapan Raya total of 50 people. The sample size was 50 people with Total Sampling and statistical test using Chi square test. The results showed that obtained P value 0.001 where P value ≤ 0.005 Ho in rejection means there is a significant relationship. The conclusion of this study is that there is a relationship between the examination of pregnancy K4 with the incidence of high risk pregnancy trimester III.</em></p><p><em><br /></em></p><p><em>Kehamilan resiko tinggi merupakan kehamilan patologi yang dapat mempengaruhi keadaan umum ibu dan bayi. Cara deteksi dini dapat dilakukan pada pelayanan antenatal care yaitu dengan peningkatan cakupan pelayanan antenatal khususnya pemeriksaan kehamilan ≥4 kali atau K4. Tujuan penelitian ini adalah untuk mengetahui hubungan pemeriksaan kehamilan K4 dengan resiko tinggi kehamilan trimester III di Puskesmas Harapan  Raya Pekanbaru tahun 2014. </em><em>Jenis penelitian kuantitatif dengan metode analitik, menggunakan pendekatan cross sectional. Populasi seluruh ibu hamil trimester III yang  melakukan pemeriksaan kehamilan di Puskesmas Harapan Raya  jumlah 50 orang. Jumlah sampel  50 orang   dengan Total Sampling dan uji statistik menggunakan  uji Chi square. Hasil penelitian menunjukkan bahwa diperoleh P value 0,001 dimana P value ≤ 0,005 Ho di tolak artinya ada hubungan yang signifikan. Simpulan dari penelitian ini yaitu ada hubungan antara pemeriksaan kehamilan K4 dengan  kejadian kehamilan resiko tinggi trimester III.</em></p><p><em><br /></em></p>


2020 ◽  
Vol 1 (2) ◽  
pp. 8-14
Author(s):  
Ketut Suarayasa ◽  
Bertin Ayu Wandira

The purpose of this study was to obtain an overview of pregnancy risk factors in pregnant women accompanied by young doctor from the IKM-KK department of the Faculty of Medicine at Tadulako University during a stase at the Primary Health Care in the city of Palu. The design of this study was descriptive in order to obtain an overview of pregnancy risk factors obtained from the checklist for assisting pregnant women. The population in this study were all pregnant women who received young doctor from the IKM-KK department in the last 2 (two) years, totaling 147 pregnant women. While the sample in this study was 3rd trimester pregnant women whose notes in the accompanying book are complete. The results showed that: 1) Compliance with the lowest Antenatal Care standard in laboratory tests (70%); 2) Pregnant Women with Low Risk Pregnancy (KRR) of 58.2%, High Risk Pregnancy (KRT) of 32.2% and Very High Risk Pregnancy (KRST) of 9.6%; 3) The three highest risk factors for pregnancy are getting pregnant too soon again <2 years (31.3%), had cesarean section (22.9%) and pre-eclampsia (16.7%); and 4) Pregnant women with very high risk pregnancies (KRST) at most (72.7%) were found in urban health centers, including: kamonji (36.3%), Singgani (18.2%) and Talise (18.2%).


2018 ◽  
Vol 1 (1) ◽  
pp. 46-53
Author(s):  
Ahmed M. M. Hany ◽  
Ahmed H. Abdellah ◽  
Ahmed H. Mohammed

Rarely does a pregnancy happen without any complication. The majority of these problems are minor and due to normal anatomical and physiological changes occurring during pregnancy. However, some are more serious and require medical attention. Certain conditions that are specific to pregnancy and occur during pregnancy classify it as a high-risk pregnancy. A high-risk pregnancy is closely monitored with antenatal check-ups and possibly an additional care. In labour, certain obstetric complications require an immediate intervention. A high-quality antenatal care means that potentially serious conditions are usually successfully managed, both during pregnancy and in labour. Post-delivery problems, either to baby or to mother, may also need medical attention with careful follow-up and sometimes referral. Thus, providing good antenatal care, finding appropriate ways of preventing, and dealing with consequences of unwanted pregnancies and improving the way society looks after pregnant women are the three most important ways to reduce maternal mortality in high risk pregnancies.


2017 ◽  
Vol 2 (2) ◽  
pp. 35
Author(s):  
Sumy Dwi Antono ◽  
Dwi Estuning Rahayu

Each pregnancy can develop normally, but it is difficult to know before that the pregnancy would be a problem, Antenatal care is an important way to monitor and support the normal maternal health and to detect any abnormalities in normal pregnancy. This study aims to determine the correlation of Pregnant mother’s Regularity in visiting Antenatal Care (ANC) on the Results from Early Detection of High Risk Pregnancy in Poli KIA  RSUD Gambiran Kediri. This research is analytic correlation using a case-control study design. The populations in this study were all third trimester pregnant mother with high risk in Poli KIA RSUD Gambiran Kediri. The number of samples is 28 people who were taken with simple random sampling technique. Measuring instruments used KIA books and Antenatal care documentation. The results will be analyzed using Chi Square test with one sample with a standard error 5% (0,05). Based on the analysis results obtained values � = 14,28 ; 3,841 so it can be stated that there is the correlation of Pregnant mother’s Regularity in visiting Antenatal Care (ANC) on the Results from Early Detection of High Risk Pregnancy in Poli KIA RSUD Gambiran Kediri. The results are mostly high-risk pregnant mother are irregular in implementing Antenatal care. The recommendations of this research is needed to conduct counseling from a health counselor to all pregnant mother about the importance of prenatal care regularly to add the knowledge about pregnancy and also to allows health workers to detect early if there is a complication of pregnancy and as an effort to increase utilization of health services for mother pregnant.; Key words : regularity of ANC, Antenatal Care (ANC), Early Detection of High Risk


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