'She Learned it from her Mother and Grandmother': Women's Experiences with Delivery and Post-partum Practices in Peri-urban Yangon, Myanmar

摘要

Background Every year in Myanmar more than one million women give birth. Although births in hospitals and those attended by skilled birth attendants have increased considerably, the majority of women continue to give birth at home. Our needs assessment explored women's reproductive health in peri-urban Yangon, a rapidly growing area characterized by poor infrastructure, slum settlements and a mobile, migrant population. In this article, we focus specifically on the perceptions and experiences of adult women, key informants, and health care providers regarding delivery and post-partum care. Methods Our study team conducted a systematic literature review, 18 key informant interviews, 27 facility surveys, a survey with 147 adult women, and seven focus group discussions with women and health care providers over the summer of 2014. We analyzed these data for content and themes using deductive and inductive techniques and used descriptive statistics to analyze the survey results. Results Women in peri-urban Yangon are increasingly choosing to give birth in hospitals; however public hospitals are often inaccessible due to financial constraints and lack of transportation. Further, sociocultural and financial considerations continue to make deliveries with a traditional birth attendant an appealing option for some women and potentially harmful traditional post-partum practices remain common. Conclusions Peri-urban populations face competing influences that guide decision-making surrounding delivery. Efforts to address the barriers to accessing hospital-based maternity services and trained providers appear warranted. The development of culturally-relevant resources that seek to raise awareness of the potential risks of traditional post-partum practices may also be of use.