Factors influencing delivery-related complications and their consequences in hard-to-reach areas of Bangladesh

Anisuddin Ahmed; Ema Akter; Abu Sayeed; Fariya Rahman; Molly Hanson; Nondo Saha; Md Refat Uz Zaman Sajib; Lubna Hossain; K M Tanvir; Aniqa Tasnim Hossain; Ritu Rana; Saraban Tahura Ether; Shafiqul Ameen; Sabrina Jabeen; A M Rumayan Hasan; Shams El Arifeen; Ahmed Ehsanur Rahman; Syed Moshfiqur Rahman

doi:10.1016/j.srhc.2024.100973

Factors influencing delivery-related complications and their consequences in hard-to-reach areas of Bangladesh

Sex Reprod Healthc. 2024 Apr 23:40:100973. doi: 10.1016/j.srhc.2024.100973. Online ahead of print.

Authors

Anisuddin Ahmed¹, Ema Akter², Abu Sayeed², Fariya Rahman², Molly Hanson³, Nondo Saha², Md Refat Uz Zaman Sajib⁴, Lubna Hossain², K M Tanvir⁵, Aniqa Tasnim Hossain², Ritu Rana⁶, Saraban Tahura Ether², Shafiqul Ameen², Sabrina Jabeen², A M Rumayan Hasan⁷, Shams El Arifeen², Ahmed Ehsanur Rahman², Syed Moshfiqur Rahman³

Affiliations

¹ Global Health and Migration Unit, Department of Women's and Children's Health, Uppsala University, Sweden; Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh. Electronic address: anisuddin.ahmed@kbh.uu.se.
² Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
³ Global Health and Migration Unit, Department of Women's and Children's Health, Uppsala University, Sweden.
⁴ Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, IL, United States.
⁵ Institute of Statistical Research & Training (ISRT), Dhaka University, Dhaka, Bangladesh.
⁶ Indian Institute of Public Health, Gandhinagar 382042, Gujarat, India.
⁷ Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.

PMID: 38678678
DOI: 10.1016/j.srhc.2024.100973

Abstract

Background and objectives: Bangladesh's high maternal mortality ratio is exacerbated by delivery-related complications, particularly in hard-to-reach (HtR) areas with limited healthcare access. Despite this, few studies have explored delivery-related complications and factors contributing to these complications among the disadvantaged population. This study aimed to investigate the factors contributing to delivery-related complications and their consequences among the mothers residing in the HtR areas of Bangladesh.

Methods: Data were collected using a cross-sectional study design from 13 HtR sub-districts of Bangladesh between September 2019 and October 2019. Data from 1,290 recently delivered mothers were analysed.

Results: Around 32% (95% CI: 29.7-34.8) of the mothers reported at least one delivery-related complication. Prolonged labour pain (21%) was the highest reported complication during the delivery, followed by obstructive labour (20%), fever (14%), severe headache (14%). Mothers with higher education, a higher number of antenatal care (ANC) visits, complications during ANC, employed, and first-time mothers had higher odds of reporting delivery-related complications. More than one-half (51%) of these mothers had normal vaginal delivery. Nearly one-fifth (20%) of mothers who reported delivery-related complications were delivered by unskilled health workers at homes. On the other hand, about one-fifth (19%) of the mothers without any complications during delivery had a caesarean delivery. Nine out of ten of these caesarean deliveries were done at the private facilities.

Conclusion: Delivery-related complications are significantly related to a woman's reproductive history and other background characteristics. Unnecessary caesarean delivery is prominent at private facilities.

Keywords: Bangladesh; Caesarean delivery; Delivery-related complications; Hard-to-reach areas; Pregnant women.