Women's authority during childbirth and Safe Motherhood in Yemen.
OBJECTIVE
In the effort to increase utilization of professional care during childbirth in low-income countries, few studies have taken a holistic approach to investigating women's perspective of safety and the link to perceived own authority at birth. The aim of the study was to examine women's authority at birth with reference to the intrapartum factors, the level of training of staff and the social and demographic background of women.


METHODS
A multistage (stratified-purposive-random) sampling process was used.


METHODS
We interviewed 220 women with childbirth experience in urban/rural Yemen. We performed bivariate chi-square tests and multiple logistic regression analysis.


RESULTS
Women who had their questions answered and requests met during childbirth had 83% higher probability (95% CI 1.66-2.02) to perceive own authority. Women who reported skin-to-skin contact/newborn in arms had 28% higher (95% CI 1.03-1.59) and those who had more distant contact 15% lower (95% CI 0.75-0.95) probability. A graded negative association was found between the perceived authority of the woman in childbirth and the level of biomedical training of staff (p<.0001). Women's social and demographic background played no role for their perceived own authority at birth.


CONCLUSIONS
This paper argues that supporting Yemeni women to exercise their own authority during childbirth would significantly facilitate their ability to give birth successfully and with personal satisfaction. In a country where women are routinely disempowered, their personal empowerment at birth is very important to them. Skilled birth assistants often, in women's perceptions, work against their personal power and authority, most especially MDs but also midwives. This failure results in women failing to seek medical care when needed. Supporting women to experience their own authority at birth would facilitate the accomplishment of both the Millennium Development Goals and those of the Safe Motherhood Initiative. We call for increased cooperation between modern and traditional methods of care.
Karolinska Institutet, Department of Public Health Sciences, National Prevention of Suicide and Mental Ill-Health, SE - 171 77 Stockholm, Sweden. annica.kempe@ki.se
Annica
A
Kempe
Fatoom A
FA
Noor-Aldin Alwazer
Töres
T
Theorell
D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D006282:Health Personnel; D006301:Health Services Needs and Demand; D006801:Humans; D007231:Infant, Newborn; D007407:Interviews as Topic; D016015:Logistic Models; D036801:Parturition; D010358:Patient Participation; D017060:Patient Satisfaction; D010465:Perception; D011181:Postnatal Care; D011247:Pregnancy; D011361:Professional Competence; D012449:Safety; D015006:Yemen; D055815:Young Adult