Factors Influencing Mothers’ Decision To Deliver Outside The Health Facility Where They Booked For Antenatal Care: Phenominological Approach, Bayelsa State.

ABSTRACT

Out of health facility delivery is highly challenging and competitive to health facility delivery

in many communities in Bayelsa State, as most women continue to engage in the practice.

Therefore, the study is to explore in-depth, the factors that influence mothers’ decision to

deliver outside health facility where they booked in Bayelsa State. Objectives were to (1)

determine personal factors that inform pregnant mother’s decision to deliver outside the health

facility of booking, (2) identify family factors influencing out-of health facility delivery, (3)

determine institutional factors responsible for their decision to deliver outside the health

facility and (4) determine health care providers factors that inform out-of-health facility

delivery by pregnant mothers. Transcendental phenomenological research design was

adopted, using non-probability sampling technique and purposive sampling methods to obtain

data from 15 participants. Validity and reliability was based on criteria for trustworthiness in a

qualitative research. Instrument for data collection was semi-structured in-depth interview

guide and tape recorder, with an in-depth face-to-face interview that lasted between 10-

35minutes (each participant). Data were analyzed using Colaizzi’s seven steps of data

analysis, presented in themes, codes and subcodes (Nvivo). Findings revealed interplay of

health institutional factors such as attitude of health staff, previous experience of the women,

lack of care and support during labour by health care provider, availability of TBA’s and the

high cost of delivery services in health facilities. Other findings include socio factors such as

distance to health facility, low educational level of respondent and religious beliefs.

Significant finding was the women’s expression of fear of Caesarean Section. However,

mothers expressed confidence in the antenatal care services where they receive information

that both mother and baby is well and safe. Hence, better to deliver at home. Thus, the

following recommendations: (i) Raised awareness on danger signs of pregnancy, labour and

delivery, (ii) Improve relationship of health care providers and the women (iii) Proper and

adequate management system, (iv) Quality assurance policy system and (v) Improving

physical access (road access).