COMPLICATIONS OF UNSKILLED HOME BIRTH: A CROSS SECTIONAL ANALYSIS OF THIRD STAGE OF LABOR.
Keywords:Key Words: Home child birth, postpartum hemorrhage, sepsis, perineal trauma, traditional birth attendants.
Introduction: Child birth at home is easily approachable but associated with certain complications which
if not dealt timely can lead to severe morbidity and even mortality of mother and child. Objective: To
evaluate the complications encountered during home birth, in women who presented to a tertiary care
hospital for further management. Methodology: A descriptive cross-sectional study was conducted at
Jinnah Postgraduate Medical Centre (JPMC) Karachi, after approval from research evaluation unit. Total
206 women, who delivered at home by traditional birth attendant/ Dai and then were referred to the
hospital obstetrical emergency unit for further management of a complicated third stage of labor, were
enrolled in the study after fulfillment of selection criteria and informed consent. Nonprobability purposive
sampling was done. Demographic and other required data was collected on predesigned proforma.
Results: Patients presented with multiple complications. Majority of patients presented with postpartum
hemorrhage due to uterine atony (56.3%), followed by retained product of conception (54.4%), retained
placenta (26.7%) and traumatic lesion (21.8%). Few (8.7%) presented with puerperal sepsis also. Most
patients presented within 24 hrs. of delivery. P-value < 0.05 was taken as significant. Conclusion: This
study concluded that home birth is associated with increased maternal morbidity, where postpartum
hemorrhage due to uterine atony is the most common presentation. Patient often present with multiple
complications, which necessitate skilled training of traditional birth attendants/Dai, in terms of prevention
of postpartum hemorrhage (including active management of third stage of labor) and infection control
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