title: Why are babies born before arrival at health facilities in King Sabata Dalindyebo Local Municipality, Eastern Cape, South Africa? A qualitative study.
abstract: BACKGROUND
  Babies born before arrival at a health facility have a higher risk of neonatal death and their mothers a higher risk of maternal death compared with those born in-facility. The study explored the reasons for mothers giving birth before arrival (BBA) at health facilities and their experiences of BBA.
  
  
  METHODS
  A qualitative research design was used. Individual and focus group interviews of BBA mothers and of nurses were undertaken at a community health centre and a district hospital in King Sabata Dalindyebo Local Municipality.
  
  
  RESULTS
  Reasons for BBA included a lack of transport, a lack of security at night that deterred mothers from travelling, precipitate labour, failure to identify true labour, and a lack of waiting areas at health facilities. Traditional and cultural beliefs favouring childbirth at homeand nurses' negative attitudes during antenatal care and labour influenced mothers to go to health facilities when in advanced labour. Mothers were aware of possible complications associated with BBA.
  
  
  CONCLUSIONS
  Socio-economic, individual, cultural and health system factors influence the occurrence of BBA. Relevant parties need to address these factors to ensure that all babies in the King Sabata Dalindyebo Local Municipality are delivered within designated health facilities.
authors: Adeyinka A
authors: AA
authors: Alabi
authors: Department of Family Medicine, Faculty of Health Sciences, Walter Sisulu University. donomahony@gmail.com.
authors: Don
authors: D
authors: O'Mahony
authors: Graham
authors: G
authors: Wright
authors: Mohlomi J
authors: MJ
authors: Ntsaba
mesh_terms: D000328:Adult; D004632:Emergency Medical Services; D005260:Female; D006268:Health Facilities; D006801:Humans; D007407:Interviews as Topic; D036801:Parturition; D011247:Pregnancy; D036301:Qualitative Research; D013019:South Africa; D013997:Time Factors; D014187:Transportation of Patients