Grand-multiparity in Saudi Arabia—examining the obstetric risk

Objectives: Grand multiparity (GMP) is a term used for women who have delivered previously five or more times. Despite availability of modern obstetrical care it still remains an obstetrical risk and obstetricians consider it as a high risk pregnancy. Occurrence of GMP in developed countries has been decreasing, with the exception in some communities like Saudi Arabia. We tried to explore the relationship between obstetrical complications and grand multiparity and find out why the problem still persists despite availability of contraceptive measures. Place and duration of study: Mother and Child Hospital, Buraidah, Al-Qassim, Saudi Arabia from Jan-June 2012. Methods and Material: It was a prospective study conducted in Mother and Child hospital. Data was collected by filling a structured Proforma. GMP and women of low parity were compared by using Student t test. GMP group was asked to explain reasons for non-practicing birth spacing. SPSS-version 19 and Microsoft office 2007 for Windows 7 was used. Independent sample t test was applied to compare the means and p-value below 0.05 was considered significant. Results: The average age of the GMP subjects of the study was 38.5 years, whilst the average age of the low parity women was 27.75 years. The highest occurrence of negative health outcome observed in the GMP group was anemia 51 (24.3%) followed by preterm labor (22.3%). Regarding the data collected on failure to use contraceptives although a number of reasons served as motivation. In order of cited prevalence, Husbands will (22.4%) and fear of family (15.9%) planning methods dominated. Conclusion and recommendations: There is a significant trend that points to GMP as an obstetric risk. The most cited reason for not using contraceptives in spite of their ready availability in Saudi Arabia was the husband’s lack of co-operation and fear of contraceptive measures. These responses provide valuable insight into the reasons for such a high number of GMP women in Saudi Arabia and serve as the basis for important dialogue and future study.