BMJ Open published an article, Access to facility delivery and caesarean section in north-central Liberia: a cross-sectional community-based study, that explores the motives of women who seek and those who do not seek institutional delivery services in north-central Liberia.
From the article:
In structured interviews conducted in villages proximate to a hospital in Nimba County, Liberia, only one in six women reported delivering their last child in a hospital, that is, 83.2% of women reported their last delivery to have been at home. Of women delivering at a regional hospital, 35.5% were by caesarean section and 8% were stillborn. These metrics indicate severe underutilisation of timely, supervised, institutional birthing services among women in north-central Liberia. Participants reported financial and transportation barriers to seeking care, as well as cultural traditions including the practice of delivery under the care of a TM. (Traditional midwife is the term used in Liberia, analogous to the traditional birth attendant in other nations.) Further, more than half of women who delivered their last child in a hospital did do so only after experiencing complications in labour at home.
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