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Title of Journal: Matern Child Health J

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Abbravation: Maternal and Child Health Journal

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Springer US

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DOI

10.1016/0168-1605(91)90092-4

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1573-6628

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Afraid of Delivering at the Hospital or Afraid of

Authors: Kathleen A CulhanePera Sarinya Sriphetcharawut Rasamee Thawsirichuchai Wirachon Yangyuenkun Peter Kunstadter
Publish Date: 2015/07/03
Volume: 19, Issue: 11, Pages: 2384-2392
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Abstract

Thailand has high rates of maternity services both antenatal care ANC and hospital delivery are widely used by its citizens A recent Northern Thailand survey showed that Hmong women used maternity services at lower rates Our objectives were to identify Hmong families’ sociocultural reasons for using and not using maternity services and suggest ways to improve Hmong women’s use of maternity services In one Hmong village we classified all 98 pregnancies in the previous 5 years into four categories no ANC/home birth ANC/home no ANC/hospital ANC/hospital We conducted lifehistory case studies of 4 women from each category plus their 12 husbands and 17 elders We used grounded theory to guide qualitative analysis Families not using maternity services considered pregnancy a normal process that only needed traditional home support In addition they disliked institutional processes that interfered with cultural birth practices distrusted discriminatory personnel and detested invasive involuntary hospital procedures Families using services perceived physical needs or potential delivery risks that could benefit from obstetrical assistance not available at home While they disliked aspects of hospital births they tolerated these conditions for access to obstetrical care they might need Families also considered cost travel distance and time as structural issues The families ultimately balanced their fear of delivering at home with their fear of delivering at the hospital Providing health education about pregnancy risks and changing healthcare practices to accommodate Hmong people’s desires for culturallyappropriate familycentered care which are consistent with evidencebased obstetrics might improve Hmong women’s use of maternity servicesFunding from Fulbright Scholarship Thailand—United States Educational Foundation Fulbright Oxfam UK Global Fund to Fight AIDS Tuberculosis and Malaria and Generosity in Action Conclusions are those of the authors Thanks to Sophie LeCoeur MD PhD coinvestigator of Access to Care in Communities Program for HIV Prevention and Treatment Chiang Mai Institute de Recherche pour le Developpement IRD France and Chiang Mai University Chiang Mai Thailand UMI 474PHPT Special thanks to the Hmong villagers who participated in research study and William Ventres MD and Sonia Patten PhD for reading prior drafts

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