|LETTER TO THE EDITOR
|Year : 2012 | Volume
| Issue : 3 | Page : 192-193
Determinants of place of delivery among booked patients in a tertiary institution
Oguntayo O Adekunle, Albert O Similoluwa
Department of Obstetric and Gynecology, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Kaduna, Nigeria
|Date of Web Publication||5-Jun-2012|
Oguntayo O Adekunle
Department of Obstetric and Gynecology, Ahmadu Bello University Teaching Hospital, Shika. Zaria, Kaduna
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Adekunle OO, Similoluwa AO. Determinants of place of delivery among booked patients in a tertiary institution. Ann Afr Med 2012;11:192-3
Pregnancy is a normal physiological event that can be complicated by pathologic process dangerous to the health of the mother and fetus in only 5-20% of cases. 
In Nigeria, 58% of pregnant women receive one form of antenatal care or the other from skilled professionals. Only 36.2% of deliveries are carried out by skilled professionals and only 5.9% of the deliveries take place in facilities meeting essential obstetric care criteria. 
The objective of this study has been to know what guides the choice of the place of delivery of the booked patients in A.B.U. Teaching Hospital, Zaria and how education, religion, parity and the time of booking affect their choice.
It is a prospective study using self-addressed, structured questionnaires completed by pregnant patients attending antenatal clinic between September 2005 and February 2006. Information regarding previous deliveries was obtained. The ward records of the number of Hospital deliveries and antenatal records were used.
Two hundred and ninety-eight questionnaires were analyzed within the six-month study period. The age range of pregnant population for the study was 17-46 years with a mean of 29.03, standard deviation of 4.74. Majority (83.9%) of the women had secondary education and above. 62.3% of them were multiparous who had antenatal care in their previous pregnancies.
Various reasons were advanced for their choice of place of delivery, ranging from position of delivery, attitude of health care providers, privacy, presence of spouse at the labor room and phobia for cesarian section [Figure 1].
|Figure 1: The Reasons for the choice of Place of Delivery amongst the booked patients|
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Primigravida would prefer to deliver in the hospital while the multiparous women would prefer it at home.
Women who had formal education desires to deliver in the hospital, while those with informal education would prefer to deliver in other places outside the hospital.
Only 13.7% of booked patients came back to deliver in our center.
The concept of antenatal care is not fully explored despite it is described in literature for over 100 years. This may be because the component of antenatal care that works is unknown. 
In our facility, a booked pregnant patient is one who has attended the booking clinic and was seen at least once thereafter, where the results of investigations are seen. This is in line with World Health Organization model which emphasizes early booking rather than number of attendances. 
The labor and delivery period though shorter than the period of pregnancy is disproportionately associated with more maternal morbidity and mortality, so much attention is needed for labor and delivery. Most of the complications that account for these deaths cannot be predicted. It occurs in the peripartum period, but it can be managed and death can be averted.
In view of the fore going, more people register for antenatal care and only 13.7% of them come back to deliver in our center or other standard centers. This is a common occurrence where patients come for antenatal care only for re-assurance. 
The above-mentioned attitude of patients should be discouraged so as to reduce maternal and perinatal morbidity and mortality.
| References|| |
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|2.||Young A, Chard T. The Effectiveness of current antenatal care. In: Studd J, editor. Progress in Obstetric and Gynaecology. Vol.12. Edinburgh: Churchill Livingstone; 1996. p. 31-46. |
|3.||WHO. Antenatal care randomized trial manual for the implementation of the new model, 2002. |
|4.||Amoti-Keguna B, Nuwaha F. Factors influencing Choice of Delivery site in Rakai District Uganda. Soc Sci Med 2000;50;203-13. |