Exploring the Drivers of Home Births: Perspectives, Risks, Benefits, and Policy Implications in Zamboanga Sibugay, Philippines

Authors

  • Marichu B. Modillas Department of Nursing, College of Arts and Sciences, Mindanao State University – Buug Campus, Buug, Zamboanga Sibugay, Philippines
  • Dave L. Oliva Department of Nursing, College of Arts and Sciences, Mindanao State University – Buug Campus, Buug, Zamboanga Sibugay, Philippines
  • Lynne Leah M. Opada Department of Nursing, College of Arts and Sciences, Mindanao State University – Buug Campus, Buug, Zamboanga Sibugay, Philippines
  • Randy Ian Gallego College of Health Sciences, Mindanao State University-Main Campus, Marawi City, Lanao del Sur, Philippines

DOI:

https://doi.org/10.26911/thejmch.2024.09.03.04

Abstract

Background: The persistence of home births in the Philippines remains conspicuous, despite the enforcement of policies discouraging this practice and the prevailing concerns about its safety. This research aims to delve into the various perspectives of women concerning home births to describe the underlying motivations behind their choices, their perceptions of the associated risks and benefits, and their stance on the “no home-birthing policy” of the state.

Subjects and Method: This was a descriptive, cross-sectional study involving 80 mothers drawn from Malangas, Zamboanga Sibugay, Philippines through a referral-based sampling method. The study examined sociodemographic characteristics as independent variables, while dependent variables included perceived reasons for home birth preference, associated risks and benefits, and respondents' views on the "no home-birthing" policy. Data were described in descriptive statistics.

Results: The findings showed that the inclination of women toward giving birth at home without the presence of professional birth attendants emanates from a multitude of factors. These include economic considerations, the sense of a familiar and comfortable environment, deeply rooted cultural beliefs, challenges related to accessibility to health facilities, and geographical impediments. Notwithstanding the inherent health risks, women opt for home births due to cost considerations, improved accessibility, and as a means of expressing their cultural and personal convictions. Consequently, the "no home-birthing policy" implemented in the Philippines is seen to reflect an effort to safeguard maternal and neonatal health by promoting facility-based deliveries.

Conclusion: The study underscores the importance of developing a holistic healthcare strategy that harmonizes women's autonomy and cultural practices with the crucial goal of ensuring safe childbirth, especially in marginalized areas.

Keywords:

home birth, traditional birth attendants, reasons, risks, benefits, no-home birth policy

References

Amit AML, Pepito VCF, De los Reyes SJ, Tang CS, Aliazas NAK, Sumpaico-Tanchanco L (2022). Prevalence and determinants of home delivery in urban and rural Philippines: Evidence from the 2017 National Demographic and Health Survey. Women’s Heal. 2022 (18): 17455057221117957. https://doi.org/10.1177%2F17455057221117957

Andrino AMP, Balasoto HIH, Bono MKG, Canindo KR, Casa LJG, Oducado RMF (2016). Reasons why women choose home birth. Asia Pacific J Multidiscip Res. 4(4): 57-63

Appiah F, Owusu BA, Ackah JA, Ayerakwah PA, Bediako VB, Ameyaw EK (2021). Individual and community-level factors associated with home birth: a mixed effects regression analysis of 2017–2018 Benin demographic and health survey. BMC Pregnancy Childbirth. 21, 547. https://doi.org/10.1186/s1288402104014x

Atukunda EC, Mugyenyi GR, Obua C, Musiimenta A, Najjuma JN, Agaba E, et al. (2020). When women deliver at home without a skilled birth attendant: A qualitative study on the role of health care systems in the increasing home births among rural women in Southwestern Uganda. Int J Womens Health. 27(12):423-434. https://doi.org/10.2147%2FIJWH.S248240

Aziato L, Omenyo CN (2018). Initiation of traditional birth attendants and their traditional and spiritual practices during pregnancy and childbirth in Ghana. BMC Pregnancy Childbirth. 18(1):64. https://doi.org/10.1186/s1288401816917

Bellini E, Macchi A, Setola N, Lindahl G (2023). Sensory design in the birth environment: learning from existing case studies. Buildings. 13(3): 604. https://doi.org/10.3390/buildings13030604

Brocklehurst P, Hardy P, Hollowell J, Linsell L, Macfarlane A, McCourt C, et al. (2012). Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the birthplace in England national prospective cohort study. BMJ. 23 (343):d7400. https://doi.org/10.1136/bmj.d7400

Bustan M, Ansariadi A, Syam E, Muis M (2019). Analysis of the relationship between Traditional Birth Attendant service and the risk of Hepatitis B transmission among Pregnant Women at the Indonesian Rural Community. Proceedings of the 3rd International Conference on Environmental Risks and Public Health, ICERPH 2018: 26-27. http://dx.doi.org/10.4108/eai.26102018.2288914

Chi PC, Urdal H (2018). The evolving role of traditional birth attendants in maternal health in post-conflict africa: A qualitative study of Burundi and Northern Uganda. SAGE Open Med. 19(6):205031211775363. https://doi.org/10.1177/2050312117753631

Devasenapathy N, George MS, Jerath SG, Singh A, Negandhi H, Alagh G, et al (2014). Why women choose to give birth at home: A situational analysis from urban slums of Delhi. BMJ Open. 4(5):e004401. https://doi.org/10.1136/bmjopen2013004401

Gabrysch S, Campbell OM (2009). Still too far to walk: Literature review of the determinants of delivery service use. BMC Pregnancy Childbirth. 11(9):34. https://doi.org/10.1186/14712393934

Gallego RIF, Abdullah AM (2021). Structured assessment, evaluation and monitoring parameters: critical correlates to the perceived effectiveness of school-based deworming programs. Mal J Med Res. 5(2):22-28. https://dx.doi.org/10.31674/mjmr.2021.v05i02.005

Gallego RIF, Abubakar JC (2019). Benal m’tobus sug m’gbata": an ethnographic exploration of the indigenous puerperal beliefs and practices of midsalipsubanen tribe of western mindanao. INSTABRIGHT e-GAZETTE. 1(2):1-13.

Gupta ML, Aborigo RA, Adongo PB, Rominski S, Hodgson A, Engmann CM, et al. (2015). Grandmothers as gatekeepers? The role of grandmothers in influencing health-seeking for mothers and newborns in rural northern Ghana. Glob Public Health. 10(9):1078-91. https://doi.org/10.1080/17441692.2014.1002413

Halfdansdottir B, Wilson ME, Hildingsson I, Olafsdottir OA, Smarason AK, Sveinsdottir H (2015). Autonomy in place of birth: a concept analysis. Med Heal Care Philos. 18(4):591-600. https://doi.org/10.1007/s110190159624y

Hollowell J, Li Y, Malouf R, Buchanan J (2016). Women’s birth place preferences in the United Kingdom: A systematic review and narrative synthesis of the quantitative literature. BMC Pregnancy Childbirth. 16(1):213. https://doi.org/10.1186/s1288401609985

Joson R (2015). Maternal mortality ratio / rate reduction in Zamboanga Peninsula. (2015)

Kanamori S, Bonhaon MD, Molon MP (2021). Negative incentives for noninstitutional births are associated with a higher rate of facility-based births in the Eastern Visayas Region, Philippines. Glob Heal Sci Pract. 9(3): 565–574. https://doi.org/10.9745%2FGHSPD2000616

Kassie A, Wale A, Girma D, Amsalu H, Yechale M (2022). The role of traditional birth attendants and problem of integration with health facilities in remote rural community of West Omo Zone 2021: exploratory qualitative study. BMC Pregnancy Childbirth. 22(1):425. https://doi.org/10.1186/s12884022047535

Kimario FF, Festo C, Shabani J, Mrisho M (2020). Determinants of home delivery among women aged 15-24 years in Tanzania. Int J Matern Child Heal AIDS. 9(2):191-199. https://doi.org/10.21106/ijma.361

MacKenzie Bryers H, van Teijlingen E (2010). Risk, theory, social and medical models: A critical analysis of the concept of risk in maternity care. Midwifery. 26(5):488-96. https://doi.org/10.1016/j.midw.2010.07.003

Morof D, Serbanescu F, Goodwin MM, Hamer DH, Asiimwe AR, Hamomba L, et al (2019). Addressing the third delay in saving mothers, giving life districts in Uganda and Zambia: ensuring adequate and appropriate facility-based maternal and perinatal health care. Glob Heal Sci Pract. 7(Suppl 1): S85–S103. https://doi.org/10.9745%2FGHSPD1800272

Moshi FV, Mbotwa CH (2020). Determinants for choice of home birth over health facility birth among women of reproductive age in Tanzania: an analysis of data from the 2015-16 Tanzania demographic and health survey and malaria indicator survey. BMC Pregnancy Childbirth. 20(1):561. https://doi.org/10.1186/s12884020032663

Nygaard SS, Kesmodel US (2018). Home births—Where are we heading? Acta Obstetricia et Gynecologica Scandinavica. 97(10):1155-1156. https://doi.org/10.1111/aogs.13441

Queremel-Milani DA, Davis DD (2023). Pain Management Medications. In StatPearls. StatPearls Publishing. 2023 Jan–. PMID: 32809527.

Reed SJ, Callister LC, Kavaefiafi A, Corbett C, Edmunds D (2017). Honoring motherhood: the meaning of childbirth for Tongan women. MCN Am J Matern Nurs. 42(3):146-152. https://doi.org/10.1097/nmc.0000000000000328

Sánchez-Redondo MD, Cernada M, Boix H, Espinosa Fernández MG, González-Pacheco N, Martín A, et al. (2020). Home births: a growing phenomenon with potential risks. An Pediatr. 93(4):266.e1-266.e6. https://doi.org/10.1016/j.anpedi.2020.04.005

Santos A (2016). Forbidding and punishing home births. Rappler (2016).

Sarker BK, Rahman M, Rahman T, Hossain J, Reichenbach L, Mitra DK (2016). Reasons for preference of home delivery with traditional birth attendants (TBAs) in Rural Bangladesh: A qualitative exploration. PLoS One. 11(1): e0146161. https://doi.org/10.1371/journal.pone.0146161

Scarf VL, Rossiter C, Vedam S, Dahlen HG, Ellwood D, Forster D, et al (2018). Maternal and perinatal outcomes by planned place of birth among women with low-risk pregnancies in high-income countries: A systematic review and meta-analysis. Midwifery. 2018 (62):240-255. https://doi.org/10.1016/j.midw.2018.03.024

Terra NO, Góes FGB, Souza AN, Ledo BC, Campos BL, Barcellos TMT (2020). Fatores intervenientes na adesão à amamentação na primeira hora de vida: revisão integrativa. Rev Eletrônica Enferm. 22(2020): 62254. https://doi.org/10.5216/ree.v22.62254.

Downloads

Published

2024-05-16

How to Cite

Modillas, M. B., Oliva, D. L., Opada, L. L. M., & Gallego, R. I. (2024). Exploring the Drivers of Home Births: Perspectives, Risks, Benefits, and Policy Implications in Zamboanga Sibugay, Philippines. Journal of Maternal and Child Health, 9(3), 315–325. https://doi.org/10.26911/thejmch.2024.09.03.04

Issue

Section

Articles