Why Do Pregnant Mothers Prefer to Give Birth at Home After they Attended Antenatal Care Visits in Southern Ethiopia? A Phenomenological Study Design

Background: Common causes of maternal deaths are direct obstetric complications that can be managed by healthcare providers in health facilities. Women giving birth at home have a higher contribution to maternal mortality and morbidity as well as a poor fetal outcome. Sub-Saharan Africa accounts for an estimated 66% of all maternal deaths. This study aimed to explore why pregnant mothers prefer to deliver at home after antenatal care follow-up in South Ethiopia. Methods: Phenomenological study design was used to explore the factors that push women to home delivery despite antenatal care being provided. A purposive technique was used to recruit the twenty pregnant mothers for the focused group discussion and ten healthcare providers for an in-depth interview. The data saturation approach determined the sample size. A focused group discussion was commenced with women who had ANC follow-ups during pregnancy gave birth at home and came for immunization services in health facilities. The in-depth interview was done with physicians, midwives, health officers, and traditional birth attendants. Data were translated into English by a bilingual translator and analyzed thematically using Open Code software. The result was presented in a table and text. Results: The study includes a total of 20 women for FGDs, seven health professionals, and three traditional birth attendants from selected health facilities. The age of most FGD participants was 25-35 years. The ideas of the participants were grouped into five themes and subthemes. Fear of health professionals’ disrespect and abuse, a family decision on the place of delivery, lack of transport and money, traditional birth attendants’ acceptability by the community, and sociocultural influences were commonly raised as barriers to institutional delivery. Conclusion: Most of the barriers are related to behavioural issues, and effort should be made to change the behaviour of the community in general. Improving the quality of the antenatal care service and adequate counseling may be an appropriate intervention to increase health facilities' delivery.