Home deliveries: reasons and adverse outcomes in women presenting to a tertiary care hospital.

OBJECTIVE To identify the reasons and adverse outcomes of home deliveries in women presenting to a tertiary care hospital. METHODS A prospective, descriptive study was undertaken in the Department of Obstetrics and Gynaecology, Unit III, Civil Hospital Karachi from 1st April, 2007 to 31st August, 2007. All patients who were admitted with any complication of home delivery during this period were included in the study. Patients and/or their attendants were interviewed to collect data regarding age, parity, sociodemographic characteristics, reasons for home delivery, presenting complaints and complications of home delivery. The data was recorded on structured questionnaires, analyzed by SPSS version 16 and presented as frequencies and percentages. RESULTS The mean age of patients was 26 +/- 5.3 years and the median parity was 2. The majority of the patients were Urdu-speaking (57.5%) followed by Sindhi (20.3%) and Balochi-speaking (11.9%). Eighty-seven percent of women had received either no or just primary education. The two most frequent reasons quoted for home deliveries were family tradition in 190 (72.8%) and lack of affordability in 179 women (68.6%). Postpartum haemorrhage was the main adverse outcome in 132 women (50.6%) followed by retained placenta/placental pieces in 74 women (28.4%). CONCLUSION The main reasons for having a home delivery are family tradition and poor socioeconomic condition of the family and the most important adverse outcomes of home delivery are postpartum haemorrhage and retained placental tissue.