Birth plans and health facility based delivery in Rural Uganda

Abstract

Objectives: To evaluate whether the completion of birth plans is associated with delivery in a health facility and the perceptual causes of birth plan completion and health facility based delivery were explored according to a well-tested health behaviour theory. Design: A community survey. Setting: Rakai and Luwero districts. Subjects: A total of 415 (202 in Rakai and 213 in Luwero district) respondents were randomly selected and interviewed using a mixed survey questionnaire composed of open and close-ended questions. Main outcome measures: Health facility based delivery. Results: The results demonstrate a statistically significant relationship between the completion of birth plans and delivery in a health facility (OR =1.86, 95% CI =1.1, 3.1). The fear of consequences of delivering at home was found to be an important driving force in promoting the completion of birth plans, thereby indirectly influencing the likelihood of delivery in a health facility. Conclusion: Given the empirical evidence presented here, this study suggests that birth plans are an important tool in improving the rate of health facility based deliveries and thus essential in the fight against maternal mortality in Uganda. It is further recommended that campaigns market the use of birth plans as a way to reduce uncertainty and manage fear and the unknown about pregnancy.