Determinants of Place of Birth in an Urban Resettlement Colony of Delhi

Introduction: Institutional births are advocated as a key strategy to reduce maternal mortality This study is aimed to identify whether the practice of place of birth is changing over time and to explore the factors contributing to women’s decision for choice of place of birth. Methods: A community based cross-sectional study was carried out in an urban resettlement colony of Delhi. A semi-structured questionnaire was used to interview the mothers with children less than or equal to 3 years of age. The place of birth was assessed in relation to socio-demographic and obstetric characteristics of the study participants. Reasons for preferring home birth were also analyzed. Results: A total of 1293 mothers were included in the study. Of these majority 1068 (82.6%) had institutional births while 225 (17.4%) were home births. A skilled birth attendant was present in only 39 (17.3%) of home births while 17 (7.5%) mothers gave birth with the help of relatives. Higher socio-economic status and higher income of the family; higher educational status of mother and head of the family was associated with institutional birth and the difference was statistically significant. Main reasons cited for preferring home birth were tradition (29.2%), financial constraints (7.3%), no one to look after (16.3%), pressure from family despite of awareness 6.3%, and other reasons. Conclusions: Institutional births have shown an increasing trend in India, however a significant proportion of women still prefer home as place of birth. Socio-cultural factors and financial constraints have an important role in MCH service utilization and need to be addressed.