title: The impact of joint partner decision making on obstetric choices and outcomes among Malawian women.
abstract: OBJECTIVE
  To determine the effects of joint partner decision making on obstetric choices and outcomes in Malawi.
  
  
  METHODS
  Between July 15, 2014 and February 25, 2015, interviews were performed with women who reported at least one lifetime pregnancy in Lilongwe District, Malawi as part of a cross-sectional study of reproductive decision making. Logistic regression models were applied to examine associations of joint decision making with delivery location and obstetric complications.
  
  
  RESULTS
  The study population included 860 women. Women who engaged in joint decision making with partners (adjusted odds ratio [aOR] 4.9; 95% confidence interval [CI] 3.3-7.2) and women whose partners made obstetric-care decisions alone (aOR 3.2; 95% CI 2.4-4.4) were more likely to undergo delivery at a healthcare facility compared with women who made obstetric-care decisions individually. In comparison with women who made obstetric decisions individually, no difference in the likelihood of experiencing obstetric complications was observed for women who engaged in joint decision making (aOR 1.1; 95% CI 0.7-1.7) or for women whose partners made decisions individually (aOR 0.8; 95% CI 0.5-1.3).
  
  
  CONCLUSIONS
  In rural Malawi, partner involvement in obstetric decision making was associated with improved obstetric choices.
authors.affiliation: The Ohio State University College of Medicine, Columbus, Ohio, USA. Electronic address: nisha.rao@osumc.edu.
authors.forename: Nisha
authors.initials: N
authors.lastname: Rao
authors.affiliation: The Ohio State University College of Public Health, Columbus, Ohio, USA.
authors.forename: Allahna
authors.initials: A
authors.lastname: Esber
authors.affiliation: The Ohio State University College of Medicine, Columbus, Ohio, USA; The Ohio State University College of Public Health, Columbus, Ohio, USA.
authors.forename: Abigail
authors.initials: A
authors.lastname: Turner
authors.affiliation: Child Legacy International, Lilongwe, Malawi.
authors.forename: Joseph
authors.initials: J
authors.lastname: Chilewani
authors.affiliation: Child Legacy International, Lilongwe, Malawi.
authors.forename: Venson
authors.initials: V
authors.lastname: Banda
authors.affiliation: The Ohio State University College of Medicine, Columbus, Ohio, USA; The Ohio State University College of Public Health, Columbus, Ohio, USA.
authors.forename: Alison
authors.initials: A
authors.lastname: Norris
mesh_terms: D000328:Adult; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D003657:Decision Making; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D006700:Home Childbirth / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008295:Malawi; D008297:Male; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012424:Rural Population; D018454:Spouses; D055815:Young Adult
keywords: Birthweight; Facility delivery; Joint decision making; Malawi; Obstetric complications; Partner decision making; Skilled birth assistant; Sub-Saharan Africa