Project – Pregnancy Duration and Choice of Antenatal and Delivery care in Idokpa community, Ikpoba Okha local government Area of Edo State.

CHAPTER ONE

INTRODUCTION

• Background to the Study

Pregnancy duration, which typically spans 40 weeks, plays a significant role in the health outcomes of both the mother and child. The duration of pregnancy often influences women’s choices in seeking antenatal and delivery care. Research indicates that prolonged pregnancies (greater than 42 weeks) are often associated with adverse maternal and neonatal outcomes, such as preeclampsia, gestational diabetes, and fetal distress (Miller et al., 2019). Conversely, pregnancies that are shorter than the typical 37 weeks may result in preterm births, which increase the risk of neonatal morbidity and mortality. In the Idokpa community of Ikpoba Okha, understanding the factors that influence the choice of antenatal and delivery care is crucial, especially since pregnancy duration may affect the need for medical interventions during both pregnancy and delivery.

In many rural communities in Nigeria, including those in Edo State, access to quality healthcare remains a challenge. Despite efforts by the government and non-governmental organizations to improve maternal health, many women in rural areas still face barriers to seeking proper antenatal care (Adeyemi et al., 2017). These barriers include cultural beliefs, economic constraints, lack of transportation, and limited availability of skilled healthcare providers. In Idokpa, a community with limited healthcare infrastructure, many women may delay seeking antenatal care or resort to traditional birth attendants due to these barriers. The decision to seek medical care may depend on perceived pregnancy risks, including the duration of the pregnancy, which could lead to early intervention or a preference for home delivery (Adeniran & Oduwole, 2020).

The choice of antenatal care is influenced by a variety of socio-cultural and demographic factors. Studies show that women who experience longer pregnancies tend to visit healthcare facilities more frequently to ensure the health of their child (Ameh et al., 2021). This is particularly the case when complications are suspected. However, in communities like Idokpa, women’s decisions on whether to use modern antenatal care often hinge on the interplay between perceived pregnancy duration, local beliefs, and personal experiences with previous pregnancies. Women who have experienced prolonged labor or complicated deliveries in the past may be more likely to seek medical care for subsequent pregnancies, while those who have had uncomplicated pregnancies may feel less urgency (Ugwu et al., 2020).

Furthermore, the place of delivery is another critical factor influenced by pregnancy duration. Rural women, including those in Idokpa, often opt for home delivery, particularly when they perceive the pregnancy to be progressing normally without complications (Ogunleye et al., 2018). The choice between home and facility delivery is often dictated by the availability of transport, healthcare professionals, and financial constraints. When a pregnancy exceeds its expected duration, however, the perceived risk of complications may prompt women to seek facility-based delivery. This is particularly relevant in the Idokpa community, where a lack of access to timely emergency care can exacerbate the risks associated with prolonged pregnancies.

In terms of healthcare provider preference, studies highlight a shift towards more women utilizing professional healthcare services as they approach the end of pregnancy. According to a study by Igwebuike et al. (2022), pregnant women in rural Nigerian communities who were aware of the risks associated with prolonged pregnancies were more likely to choose hospital-based deliveries. This choice is often influenced by education, the presence of skilled birth attendants, and the availability of essential medical services. The duration of pregnancy, particularly when exceeding the expected term, may prompt women to seek professional care in anticipation of the potential complications associated with post-term pregnancies, such as the increased likelihood of stillbirth or need for medical induction.

The choice of antenatal and delivery care in the Idokpa community of Ikpoba Okha Local Government Area is shaped by various factors, with pregnancy duration being a significant determinant. While women in this rural area face significant barriers to accessing quality maternal healthcare, a growing awareness of the risks associated with extended pregnancies may influence their decision to seek formal healthcare. Improving the accessibility of healthcare facilities, educating women about pregnancy risks, and addressing the socio-economic barriers to care are crucial steps in enhancing maternal health outcomes in the community. Future interventions should focus on integrating traditional beliefs with modern healthcare practices to ensure that pregnant women make informed decisions about their antenatal and delivery care.

1.2. Statement of the Problem

In Idokpa, a rural community within Ikpoba Okha Local Government Area of Edo State, the choice of antenatal and delivery care remains a critical public health issue. While maternal and child health have improved over recent decades in many urban areas of Nigeria, rural communities like Idokpa continue to face significant challenges in accessing quality maternal healthcare services. A crucial aspect of maternal healthcare is pregnancy duration, which can influence the health outcomes of both the mother and the newborn. Despite the known risks associated with pregnancies that extend beyond the typical 40 weeks (such as fetal distress, stillbirth, or the need for medical intervention), many women in Idokpa, especially in rural and underserved areas, remain unaware of these risks or face barriers that prevent them from seeking timely medical care.

In Idokpa, socio-economic factors, traditional beliefs, and logistical barriers such as poor transportation, inadequate healthcare facilities, and limited access to skilled healthcare providers significantly impact women’s decisions to seek antenatal and delivery care. These factors are exacerbated in cases of prolonged pregnancies, where a woman’s choice of delivery care may be heavily influenced by perceptions of pregnancy duration, prior birth experiences, and local customs. Women in the community often rely on traditional birth attendants or choose home deliveries due to cultural norms or economic constraints, despite the availability of healthcare facilities. As a result, complications from prolonged pregnancies may go unaddressed, leading to preventable maternal and neonatal health issues.

Despite some efforts by both governmental and non-governmental organizations to improve maternal healthcare services in Edo State, there remains a lack of comprehensive data specific to the Idokpa community regarding the influence of pregnancy duration on antenatal and delivery care choices. The lack of research on how pregnancy duration specifically affects decision-making in this rural context has hindered the development of targeted interventions. This gap in knowledge is particularly important given the known association between pregnancy duration and health risks that may require more specialized care, such as induction of labor or cesarean delivery.

Therefore, this study aims to investigate the relationship between pregnancy duration and the choice of antenatal and delivery care in Idokpa, to identify the factors influencing these choices, and to explore the challenges women face in accessing appropriate maternal healthcare. Addressing this knowledge gap is essential for developing culturally appropriate interventions to improve maternal health outcomes in the community and reduce the risks associated with prolonged pregnancies. Understanding these dynamics can help inform policies and programs that promote safer pregnancy outcomes, encourage the use of skilled care during childbirth, and ultimately reduce maternal and infant morbidity and mortality in rural Edo State.

1.3. Aim and Objectives of the Study

The aim of the study is to examine the pregnancy Duration and Choice of Antenatal and Delivery care in Idokpa community, Ikpoba Okha local government Area of Edo State. The specific objectives are:

1. To assess the average duration of pregnancy among women in the study population.
2. To determine the factors influencing the choice of antenatal care services among pregnant women.
3. To evaluate the quality of antenatal care received by pregnant women in the study.
4. To examine the reasons behind the choice of delivery care options among pregnant women.

 

1.4. Research Questions

The research questions are buttressed below:

1. What is the average duration of pregnancy among women in the study population?
2. What factors influence the choice of antenatal care services among pregnant women?
3. How is the quality of antenatal care received by pregnant women in the study population evaluated?
4. What are the reasons behind the choice of delivery care options among pregnant women in the study population?

1.5. Research Hypothesis

The hypothetical statement of the study is buttressed below:

Ho: Quality of antenatal care received have no significant effect on pregnant women.

H1: Quality of antenatal care received have significant effect on pregnant women.

1.6. Significance of the Study

This study is significant as it addresses a critical gap in understanding how pregnancy duration influences the choice of antenatal and delivery care in rural communities like Idokpa, Ikpoba Okha Local Government Area of Edo State. Pregnancy duration, particularly when it deviates from the typical 37 to 42-week period, can have significant implications for maternal and neonatal health. By focusing on how this factor affects healthcare-seeking behavior, the study provides valuable insights into the health risks women in Idokpa face and the barriers that prevent them from accessing timely and appropriate care. Given the lack of local studies in this area, the findings can be used to inform both local and regional maternal healthcare policies and interventions.

First and foremost, the study highlights the importance of improving maternal and child health outcomes in rural Edo State, an area that is often underserved in terms of healthcare infrastructure. In rural communities like Idokpa, cultural norms, socio-economic constraints, and logistical challenges often determine whether women seek antenatal and delivery care. By exploring how pregnancy duration influences the decisions of women in these communities, the study will help identify the specific barriers that prevent timely medical interventions, especially for women with prolonged pregnancies. This understanding is essential for designing more effective maternal health programs that can reduce preventable complications and promote safer pregnancies.

Furthermore, the research provides an opportunity to assess the extent to which traditional practices, including the reliance on traditional birth attendants (TBAs), impact the health outcomes of pregnant women, particularly those with extended pregnancies. In many rural settings, women who experience prolonged pregnancies may choose to deliver at home or with unskilled attendants due to cultural beliefs or limited access to medical facilities. By examining these choices, the study can help assess the potential risks involved and the degree to which women are making informed decisions about their care. This understanding can guide the development of community-based health education programs aimed at increasing awareness of the importance of medical intervention during complicated pregnancies.

Another significant aspect of this study is its potential to inform future maternal health interventions and policies in Edo State. Policymakers and healthcare providers need a deeper understanding of the local context in order to implement strategies that address the unique challenges faced by rural populations. By exploring the links between pregnancy duration, care choices, and health outcomes, the study will provide evidence that can be used to advocate for improved healthcare facilities, better transportation options, and increased availability of skilled birth attendants in rural areas. This can lead to more targeted interventions that specifically address the needs of rural women with prolonged pregnancies, ultimately reducing maternal and infant mortality rates.

Moreover, the findings of this study will contribute to the broader body of knowledge on maternal health in sub-Saharan Africa. Although much research has been conducted on maternal health in urban and peri-urban settings, less attention has been given to rural communities with limited healthcare access. This research will offer new perspectives on how pregnancy duration interacts with various socio-cultural, economic, and healthcare-related factors to shape maternal health behaviors. By focusing on rural Edo State, the study will fill an important gap in the literature and provide a more nuanced understanding of the challenges and opportunities for improving maternal healthcare in similar contexts across the region.

Lastly, this study has the potential to foster a more integrated approach to maternal health in Idokpa, combining modern healthcare practices with traditional beliefs in a culturally sensitive way. Understanding how pregnancy duration affects decision-making can guide healthcare providers to tailor their services to local needs, ensuring that women feel empowered to seek appropriate care. This could involve improving community health outreach programs, strengthening the role of skilled birth attendants, and promoting the use of healthcare facilities, particularly for women at risk due to pregnancy duration. Ultimately, the study’s findings may play a key role in improving maternal health outcomes in Idokpa and similar rural communities in Edo State, helping to reduce the maternal and neonatal health disparities that exist between urban and rural populations in Nigeria.

1.7. Scope of the Study

The study examines pregnancy Duration and Choice of Antenatal and Delivery care in Idokpa community, Ikpoba Okha local government Area of Edo State.

1.8. Operational Definition of Terms

1. Pregnancy Duration: Pregnancy duration refers to the length of time a woman is pregnant, typically measured from the first day of her last menstrual period (LMP) to the time of delivery. A normal pregnancy usually lasts about 40 weeks (around 9 months), though it can range from 37 to 42 weeks. Pregnancies that extend beyond 42 weeks are considered post-term, and those that end before 37 weeks are classified as preterm. The duration of pregnancy is an important factor in determining the health risks for both the mother and the baby, as prolonged or preterm pregnancies may require specialized care and intervention during labor and delivery to prevent complications.
2. Choice: In the context of pregnancy and childbirth, “choice” refers to the decisions made by a pregnant woman regarding the type of care and services she seeks during her pregnancy and delivery. This includes decisions about whether to receive antenatal care, where to deliver (e.g., home delivery versus hospital or healthcare facility), and the type of birth attendant (e.g., skilled professional such as a doctor or midwife, or traditional birth attendants). These choices are influenced by several factors, including cultural beliefs, personal preferences, economic circumstances, accessibility of healthcare, and perceived risks associated with pregnancy duration or complications.
3. Antenatal Care: Antenatal care (ANC) refers to the medical care provided to a pregnant woman throughout the course of her pregnancy. It is aimed at monitoring the health of both the mother and the developing fetus, preventing complications, and providing education about childbirth, breastfeeding, and newborn care. Antenatal care typically involves regular check-ups with a healthcare provider, screening tests, blood work, and ultrasounds to ensure the pregnancy is progressing normally. The goal of antenatal care is to identify potential risks early, address any health issues, and ensure that the mother is prepared for childbirth.
4. Delivery Care: Delivery care refers to the care and medical assistance provided during childbirth, encompassing the management of labor, delivery, and immediate postpartum care for the mother and baby. Delivery care can occur in various settings, such as home births, healthcare facilities, or hospitals, and is typically provided by trained healthcare professionals such as obstetricians, midwives, and nurses. Delivery care includes ensuring safe labor and delivery practices, managing complications (such as breech presentation, excessive bleeding, or fetal distress), performing necessary medical interventions (e.g., cesarean section or induction of labor), and providing immediate care to the newborn (e.g., resuscitation, breastfeeding initiation). Skilled delivery care is essential for reducing maternal and neonatal morbidity and mortality.

 

Project – Pregnancy Duration and Choice of Antenatal and Delivery care in Idokpa community, Ikpoba Okha local government Area of Edo State.