Gestational age at initiation of antenatal care in a tertiary hospital, Southwestern Nigeria

CONTEXT

Antenatal care utilization has been shown to be associated with reduction in maternal and perinatal morbidity and mortality while early initiation provides an opportunity for optimum utilization of this care with improved maternal and fetal outcomes.

AIM

This study seeks to determine the time of initiation of antenatal care among pregnant women and possible factors influencing such timing.

SETTING

A cross-sectional study involving 530 pregnant women was carried out at the booking clinic of the Ekiti State University Teaching Hospital, Ado-Ekiti, between September 03, 2013, and March 04, 2014.

SUBJECTS AND METHODS

A pretested questionnaire was administered to them to obtain information on their sociodemographic characteristics and factors influencing their timing of antenatal care initiation.

RESULTS

The prevalence of early booking in this study was 22.7%, and the mean gestational age at booking was 21.09 ± 6.98 weeks. The age, parity, and occupation of the women and counseling on early booking were significantly associated with early booking among the respondents with P value of 0.010, 0.006, 0.011, and 0.009, respectively while on logistic regression, the occupation of women was the only significant association with early antenatal care initiation (adjusted odd ratio 0.388; confidence interval 0.212-0.710; P = 0.002). Complications experienced in previous pregnancies did not predict early initiation of care. More than half of the respondents (50.9%) gave early monitoring of their pregnancy as the reason for initiating the care.

CONCLUSION

Late initiation of antenatal care is still prevalent in our environment. Therefore, pregnant women should be adequately informed about the concept of early antenatal registration.

Cesarean section on maternal request: the viewpoint of expectant women

PURPOSE

To determine the women's perception and factors influencing willingness to have cesarean section on maternal request (CSMR) in the absence of medical or obstetric indication.

METHODS

A cross-sectional questionnaire-based survey of 752 antenatal clinic attendees at Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti. Pre-tested questionnaires were used to elicit information on socio-demographic and obstetric variables, awareness and perspective of CSMR and the willingness to request CS without physician's recommendation. Frequency tables were generated and univariate and multivariate logistic regression were used to determine factors that influenced CSMR using SPSS software version 16.0.

RESULTS

Forty-eight (6.4 %) of the respondents reported willingness to request CS. The most common motivations for the request were fear of losing the baby during labor, delay in conception and fear of labor pains. Analysis by simple logistic regression and multiple regression showed age, parity and educational status were not significantly related to the decision for CSMR.

CONCLUSION

CSMR is an evolving entity in obstetrics practice in the developing countries. Delay in conception, fear of labor pain and loss of baby during labor appear to be strong motivations.