Publication: Maternal and Perinatal outcome among the booked and unbooked pregnancies from catchments area of BP Koirala Institute of Health Sciences, Nepal
Date
2007
Journal Title
Journal ISSN
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Publisher
Kathmandu University
Abstract
Objectives: To examine the differences in maternal and perinatal outcome among booked and unbooked pregnant
women and their perception for underutilization of services targeted for them.
Methods: Two thousand two hundred and twenty eight pregnant women, booked and unbooked, attending
emergency obstetrics care during Jan.-Dec. 2005, were included in the study; Investigators followed cases till
discharge.
Results: Tendency for mothers to be booked was found to be significantly associated with age. Booked and
unbooked mothers differed by distance to the hospital and parity. There was difference between the periods of
gestation at which they presented to the hospital among both the groups (p<0.0001). Nearly eighty percent (81.4%)
of unbooked mothers did not know the period of gestation. Most of these women conceived during lactational or
depo provera-induced amenorrhea. The maternal mortality rate for unbooked mothers was 16 out of 1056 and none
among the booked. Perinatal mortality is 3 times less in booked mothers. Higher perinatal mortalities are associated
with unbooked mothers and had a higher proportion of maternal intensive care unit admissions and perinatal deaths
compared with the booked group. Focus group discussion revealed that the reasons for underutilizations of services
are; Distance, cost, disempowerment of women and attitudes of hospital personnel.
Conclusion: The opportunities to enhance utilizations are based on distance, cost and client friendly environment of
hospital personnel. It has been observed, building teaching hospitals alone, will not have much impact to maternal
and perinatal outcome, unless peripheral health institutions are equipped with facilities and service provisions.
Keywords: Booked mothers, Unbooked mothers, maternal complication, perinatal outcome.
Description
Pokharel HP 1, Lama GJ 1, Banerjee B 1, Paudel LS 2 , PK Pokharel 2
1Department of Obstetrics & Gynecology, 2 Community Medicine, B.P.Koirala Institute of Health Sciences, Dharan, Nepal