Why Women Choose to Delivery at Home in India: A Study of Prevalence, Factors, and Socio-Economic Inequality

Abstract Background: Most of childbirth complications usually arise during the time of delivery and are difficult to predict, but can be effectively managed through delivery at the health facility equipped with skilled birth attendants placed in an enabling environment. Despite many efforts put by the Government to reduce maternal and neonatal deaths through institutional birth deliveries, statistics suggest that these deaths are still very high in India. This study sought to determine the prevalence of home births and identifying the factors influencing women choice.Methods: Data from the National Family Health Survey (NFHS) conducted during 2005-06 and 2015-16 was used in the study. The respondents were women 15-49 years, a sample of 36,850 and 1, 90,898 women from two time period were included in the study. Multivariate logistic regression was used to determine the factors influencing home delivery. Results: Women’s who give birth at home has reduced by 39.6% from 58.5%. As compared to women below 18 years, those who were above 25 years were less likely to give birth at home [OR: 0.57; CI: 0.49-0.68] and [OR: 0.76; CI:0.70-0.82]. Women with full ANC visit were less likely to give birth at home as compare to women with no ANC visit [OR: 0.34; CI: 0.28-0.41] and [OR: 0.41; CI: 0.38-0.45]. In central India the odds of delivering babies at home was high in 2005-06 [OR: 1.15; CI: 1.01-1.32] whereas in 2015-16 the situation was opposite [OR: 0.92; CI: 0.87 -0.98] in reference to women from north India. Conclusion: There is a need to promote institutional deliveries, special focus to be given to poor women, women with higher parity, uneducated women, and rural women. Much work needs to be done in the rural parts of the country as rural women were more likely to opt for home delivery than their counterparts.