Delivery Safety of Women from Tribal and Non-tribal Areas, in the State of Maharashtra, India

Abstract

Aims: The study was conducted to obtain information about place and mode of child delivery and compare unsafe deliveries between tribal and non-tribal areas. Study Design: This was a retrospective study with the follow up of registered pregnant women in the Primary Health Centers (PHC). Place and Duration of Study: The study was conducted in the PHCs of the State of Maharashtra, India. They were divided into two groups, tribal and non-tribal. The study was carried out in 2009-10. Method: A format was prepared to obtain details of delivery of children by women. The Auxiliary Nurse Midwives filled the format for all the pregnant women registered during calendar year 2008, through house to house visits in their respective areas. Results: More than one million pregnancies were registered. There were 21.88% home deliveries, of which 6.96% were not attended by a skilled birth attendant. About 5% of the babies were delivered through Cesarean section. The proportion of home deliveries (46.79%) and the absence of a skilled birth health professional (16.19%) were significantly higher in tribal areas. Even in institutional deliveries, interventional assistance was offered to lesser extent in these areas. The relative risk of undergoing unsafe delivery was 3.25 (95%, C.I. 3.20-3.29) in tribal PHCs. The district wise analysis also supported the findings that home deliveries and overall unsafe deliveries were more in tribal districts. Conclusion: The study concludes that substantial number of women from tribal areas is exposed to unsafe deliveries.