Childbirth Practices in the Akpabuyo Rural Health and Demographic Surveillance System

Maternal and neonatal mortality remain high in Nigeria. The State and Federal governments have adopted several strategies to prevent maternal and infant deaths such as the Cross River State Free Health Services to pregnant women and infants, and the National Midwives’ Service Scheme. This study assessed pregnancy and childbirth practices of Nigerian women in rural communities located in Akpabuyo in the Niger Delta region of Nigeria. Women who were pregnant or had recently given birth in a population of 5,668 people under surveillance in some rural communities of Akpabuyo were interviewed to obtain information on pregnancy and childbirth practices. Validated semi-structured questionnaires were administered by well-trained field workers. Completed questionnaires were entered into electronic data forms in OpenHDS software and exported to STATA for analysis. Results showed that, 39.5% of women reported that they had sought prenatal care from a traditional birth attendant (TBA). 84.6% of all births occurred outside the formal health system with the majority attended by TBAs. Only 15.4% of births occurred in hospitals or health centres. The implements used to cut the umbilical cord were knives (46.2%), new razor blades, old razor blades, sharp stone and scissors. The materials used for treating the umbilical cord were mostly methylated spirit (63.1%); other treatment materials were“western medicine”, “black powder” and others including herbs and earth. The study concluded that, childbirth practices that pose significant risk to maternal and newborn health remain common in these rural communities. Majority of births were attended by TBAs despite free delivery services available at the formal health facilities. TBAs should be assisted to enhance their role in health care delivery. Effort should be made to increase public awareness and interest in facility-based services. Keywords: Maternal health, neonatal infection, longitudinal data, pregnancy