title: Role of the spiritual churches in antenatal clinic default in Calabar, Nigeria.
abstract: OBJECTIVE
  To establish the role played by spiritual churches in the observed increase rate of antenatal clinic default in Calabar, Nigeria.
  
  
  METHODS
  Cross sectional comparative study.
  
  
  METHODS
  Calabar, an urban community, the capital of Cross River State in south-eastern part of Nigeria.
  
  
  METHODS
  Women who booked for antenatal care in the University of Calabar Teaching Hospital but delivered outside orthodox health facilities.
  
  
  RESULTS
  A total of 44.3%, of our antenatal clinic defaulters delivered in spiritual churches. Fear of spiritual attack by wicked people and prophetic warning in church (48.3%) and high hospital bills (26.8%) were the major reasons for this act. Perineal tear, primary postpartum haemorrhage and prolonged labour were associated more with delivery in church than hospital delivery or home delivery or delivery by TBAs (p < 0.01). Birth asphyxia and birth trauma were also significantly higher in church than hospital and other unorthodox delivery centres (p < 0.01). All the maternal deaths occurred in church and perinatal mortality was higher in church than other delivery facilities.
  
  
  CONCLUSIONS
  The spiritual churches play a major role in the increasing rate of antenatal clinic default in Calabar. The pregnancy outcome in these spiritual churches is worse than when delivered in hospital, by TBAs or at home. Adequate health education; reduction in delivery fees in hospitals and general improvement in the socio-economic status of the populace may help reduce these high maternal and perinatal morbidity and mortality in the spiritual churches.
authors.affiliation: Department of Obstetrics and Gynaecology, College of Medical Sciences, University of Calabar, Nigeria.
authors.forename: S J
authors.initials: SJ
authors.lastname: Etuk
authors.forename: I H
authors.initials: IH
authors.lastname: Itam
authors.forename: E E
authors.initials: EE
authors.lastname: Asuquo
mesh_terms: D016550:Birthing Centers / Q000458:organization & administration*; D002977:Clergy; D005260:Female; D006700:Home Childbirth / Q000009:adverse effects*; D006785:Hospitals, University; D006801:Humans; D016488:Medicine, African Traditional; D008880:Midwifery / Q000458:organization & administration*; D009017:Morbidity; D020380:Needs Assessment; D009549:Nigeria / Q000453:epidemiology; D010865:Pilot Projects; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011295:Prenatal Care / Q000706:statistics & numerical data*; D016312:Treatment Refusal / Q000523:psychology* / Q000706:statistics & numerical data*; D014504:Urban Health / Q000706:statistics & numerical data