Male involvement in birth preparedness and complication readiness for emergency obstetric referrals in rural Uganda

Background: Every pregnant woman faces risk of life-threatening obstetric complications. A birth-preparedness package promotes active preparation and assists in decision-making for healthcare seeking in case of such complications. The aim was to assess factors associated with birth preparedness and complication-readiness as well as the level of male participation in the birth plan among emergency obstetric referrals in rural Uganda. Methods: This was a cross-sectional study conducted at Kabale regional hospital maternity ward among 140 women admitted as emergency obstetric referrals in antenatal, labor or the postpartum period. Data was collected on socio-demographics and birth preparedness and what roles spouses were involved in during developing the birth plan. Any woman who attended antenatal care at least 4 times, received health education on pregnancy and childbirth danger signs, saved money for emergencies, made a plan of where to deliver from and made preparations for a birth companion, was deemed as having made a birth plan. Multivariate logistic regression analysis was conducted to analyze factors that were independently associated with having a birth plan. Results: The mean age was 26.8 +/- 6.6 years, while mean age of the spouse was 32.8 +/- 8.3 years. Over 100 (73.8%) women and 75 (55.2%) of their spouses had no formal education or only primary level of education respectively. On multivariable analysis, Primigravidae compared to multigravidae, OR 1.8 95% CI (1.0-3.0), education level of spouse of secondary or higher versus primary level or none, OR 3.8 95% CI (1.2-11.0), formal occupation versus informal occupation of spouse, OR 1.6 95% CI (1.1-2.5), presence of pregnancy complications OR 1.4 95% CI (1.1-2.0) and the anticipated mode of delivery of caesarean section versus vaginal delivery, OR 1.6 95% CI (1.0-2.4) were associated with having a birth plan. Conclusion: Individual women, families and communities need to be empowered to contribute positively to making pregnancy safer by making a birth plan.