Dataset Information

Perceived causes of adverse pregnancy outcomes and remedies adopted by Kalenjin women in rural Kenya.

ABSTRACT:

Background

There have been few studies about the basis on which women in developing regions evaluate and choose traditional rather than western maternal care. This qualitative study explores the socio-cultural perceptions of complications associated with pregnancy and childbirth and how these perceptions influence maternal health and care-seeking behaviours in Kenya.

Methods

Kalenjin women (n?=?42) aged 18-45 years, who were pregnant or had given birth within the last 12 months, were interviewed. A semi-structured interview guide was used for data collection. A further nine key informant interviews with Traditional Birth Attendants (TBAs) who were also herbalists (n?=?6), community health workers (CHWs) (n?=?3) and a Maternal and Child Health (MCH) nursing officer (n?=?1) were conducted. The data were analysed using MAXQDA12 software and categorised, thematised and analysed based on the symbolic dimensions of Helman's (2000) ill-health causation aetiologies model.

Results

Pregnancy complications are perceived as the consequence of pregnant women not observing culturally restricted and recommended behaviour during pregnancy, including diet; physical activities; evil social relations and spirits of the dead. These complications are considered to be preventable by following a restricted and recommended diet, and avoiding heavy duties, funerals, killing of animals and eating meat of animal carcasses, as well as restricting geographical mobility, and use of herbal remedies to counter evil and prevent complications.

Conclusion

Delay in deciding to seek maternal care is a result of women's failure to recognise symptoms and maternal health problems as potential hospital cases, and this failure stems from culturally informed perceptions of symptoms of maternal morbidity and pregnancy complications that differ significantly from biomedical interpretations. Some of the cultural maternal care and remedies adopted to prevent pregnancy complications, such as restriction of diet and social mobility, may pose risks to the pregnant woman's health and access to health facilities whereas other remedies such as restricting consumption of meat from animal carcasses and heavy duties, as well as maintaining good social relations, are cultural adaptive mechanisms that indirectly control the transmission of disease and improve maternal health, and thus should not be considered to be exclusively folk or primitive.

SUBMITTER: Riang'a RM

PROVIDER: S-EPMC6194609 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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Publications

Perceived causes of adverse pregnancy outcomes and remedies adopted by Kalenjin women in rural Kenya.

Riang'a Roselyter Monchari RM Nangulu Anne Kisaka AK Broerse Jacqueline E W JEW

BMC pregnancy and childbirth 20181019 1

<h4>Background</h4>There have been few studies about the basis on which women in developing regions evaluate and choose traditional rather than western maternal care. This qualitative study explores the socio-cultural perceptions of complications associated with pregnancy and childbirth and how these perceptions influence maternal health and care-seeking behaviours in Kenya.<h4>Methods</h4>Kalenjin women (n = 42) aged 18-45 years, who were pregnant or had given birth within the last 12 months, w ...[more]

PMID: 30340547

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Project description:As mothers age, the risk of adverse pregnancy outcomes may increase, but the results so far are controversial and several issues remain unknown, such as the impact of maternal weight on the effects associated with older age. In a prospective cohort of 912 Polish women with singleton pregnancies (recruited in 2015-2016), we assessed the pregnancy outcomes depending on the mother's age (18-24, 25-29, 30-34, 35-39, and ≥40 years). Women aged ≥35 years (vs. <35 years) were assessed in terms of body mass index (BMI). Multidimensional logistic regression was used to calculate the odds ratios (with 95% confidence intervals) of the pregnancy results. The risk profiles (using the Lowess method) were applied to determine the threshold risk. We found that both the youngest and the oldest group members displayed higher adjusted odds ratios of preeclampsia (PE), intrauterine growth restriction (IUGR), and preterm birth <37th week (U-shaped risk). In the remaining cases, the age ≥40 years, compared to the youngest age 18-24 years, was associated with a higher adjusted risk of gestational hypertension (GH) (AOR = 5.76, p = 0.034), gestational diabetes mellitus GDM-1 (AOR = 7.06, p = 0.016), cesarean section (AOR = 6.97, p <0.001), and low birth weight LBW (AOR = 15.73, p = 0.033) as well as macrosomia >4000 g (AOR = 8.95, p = 0.048). We found that older age ≥35 years (vs. <35 years) was associated with higher adjusted odds ratios of all the pregnancy outcomes investigated. In obese women, these adverse older age related results were found to be more intense in GH study, as well as (though weaker) in birth <37th week study, small-for-gestational age birth weight (SGA), LBW, large-for-gestational age birth weight (LGA), and macrosomia. In overweight women, these adverse older age related results were found to be more intense in preterm birth study, as well as (though weaker) in SGA and LBW. In underweight women, adverse pregnancy outcomes related to older age were more intense in a study of cesarean section. At the same time, underweight was associated with reversal of some negative effects of older age (we found lower odds ratios of GDM-1 diabetes). The maternal threshold age above which the risk of GH, PE, GDM, caesarean section, and preterm birth increased was 33-34 years (lower than the threshold of 35 years assumed in the literature), and the threshold risk of IUGR, LBW, SGA, LGA, and macrosomia was 36-37 years. Main conclusions: Older maternal age was associated with a higher chance of all kinds of obstetric complications. Older women should particularly avoid obesity and overweight.

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Dataset Information

Perceived causes of adverse pregnancy outcomes and remedies adopted by Kalenjin women in rural Kenya.

Background

Methods

Results

Conclusion

Publications

Perceived causes of adverse pregnancy outcomes and remedies adopted by Kalenjin women in rural Kenya.

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