Abstract

This study was prompted by the poor maternal and foetal outcome at Harare Maternity Hospital, Zimbabwe, in unbooked mothers compared to women who had booked for antenatal care. Comparison was made of 195 recently delivered unbooked mothers with 196 booked mothers. Unbooked mothers were significantly more likely to be younger, of lower parity, be single, have lower socio-economic status, live in or migrate from rural areas, be uneducated and have an unwanted pregnancy. Their infants were significantly more likely to preterm and/or of low birth weight and had a higher perinatal mortality. The major reasons cited by the women for not booking were lack of money and delivery occurring before the intended time of booking. Discussion focuses on how to improve outcome in unbooked mothers.

PIP:

Levels of perinatal and maternal mortality in the Greater Harare Maternity Unit in Harare, Zimbabwe, are markedly higher among women who do not book for antenatal care compared to women who do book. The authors used a case-control approach to determine which factors are related to unbooked and booked mothers, respectively, and reasons for the failure to book for antenatal care. 195 recently delivered unbooked mothers were compared against 196 booked mothers over the period January-March 1986, during which there were a total of 40,379 deliveries at the hospital. Data were collected via personal interview on the day of delivery or the day after. Unbooked mothers were significantly more likely to be younger, of lower parity, single, of lower socioeconomic status, live in or migrate from rural areas, be uneducated, and have an unwanted pregnancy. Their infants were significantly more likely to be preterm and/or of low birth weight and had an higher level of perinatal mortality. Major reasons cited by the women for not booking were lack of money and delivery occurring before the intended time of booking. The discussion focuses upon how to improve outcomes in unbooked mothers. Unbooked mothers are an high-risk group which should be targeted for antenatal care and early booking. Concern is also expressed that the universal introduction of user charges for maternity care under the Economic Structural Adjustment Program will further deter the high-risk group from availing themselves of antenatal care.