EXPLORING THE RECOGNITION OF AND INITIAL RESPONSE TO PROLONGED LABOR AND BIRTH ASPHYXIA IN DHAKA, DINAJPUR, AND MATLAB, BANGLADESH

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Abstract

Purpose: This study investigated the knowledge and behaviors of Bangladeshi women and their caregivers regarding the recognition of and initial response to prolonged labor (PL) and birth asphyxia (BA) in homebirth settings. Methods: Survey data on cultural knowledge about the causes, signs, and treatments for PL/BA were collected through structured interviews of 360 randomly-selected respondents. Integrated illness history (IIH) narratives were conducted with women who experienced PL/BA and their caregivers (n=19 PL, 16 BA groups). Congruence was determined between structured interviews and IIH interviews. Results: PL: The highest rates of congruence (ie, agreement between knowledge and behavior) occurred when perceived cause was malnourishment of mother/baby, treatment was seeking professional care, and symptom was increasing pain strength. The highest rates of incongruence occurred when perceived cause was spirits. BA: The highest rates of congruence occurred when perceived cause was PL, treatments were stimulating the baby and seeking professional care, and symptom was baby's inability to move. The highest rates of incongruence occurred when perceived cause was spirits, treatments were covering and oil-massaging the baby, and symptom was baby's inability to cry. Conclusions: During complications, inconsistency between knowledge and behavioral response may delay the seeking of appropriate care, adversely impacting outcomes. Causes, signs, symptoms, and treatments eliciting these responses should be addressed appropriately. Funding: Scholarly Inquiry and Research at Emory (SIRE), Global Health Institute, Emory University.

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