SOCIAL FACTORS INVOLVED IN WOMEN AVOIDING EARLY ANTENATAL BOOKING IN ARMY SETUP

Social Factors Involved in early Antenatal Booking

Abstract

Objectives: To study the factors involved in women avoiding early antenatal booking coming to Military Hospital Rawalpindi.
Study Design: Comparative cross sectional study.
Place and duration: Dept of Gynae and Obstetrics, Military Hospital, Rawalpindi. Tertiary care centre from whole of the Pakistan dealing with other ranks of Pak Army, from July to December 2006. 
Subjects and Methods: Study was done on 1000 patients at maternity OPD.  Patients were divided into two groups of 500 each. Those patients who had early antenatal booking and took regular advice during pregnancy were included in group-I. While group-II included those patients who were late in antenatal booking or remained unbooked till delivery or presented with complications in 3rd trimester for the 1st time. Patients demographic data was entered on questionnaire and factors involved were interpreted. Data was analyzed by using computer software programme SPSS version 11.  Chi square test was used to see the significance of difference between group-I and group-II and results were considered significant if P value is less than 0.05.
Results: The study showed that as compared to booked patients factors involved in late booking of pregnant women were fear of invasive treatment (C-Section, Episiotomy) (40%), dai system (26%), education less than middle (19%), not living with husband (18%), far distance from hospital (14%), financial restraints (10%)and self medication (05%), (P value < 0.05). Anemia was significantly lower among women utilizing antenatal care early (3.8%), as compared to those who were late at booking (17.8%), (P value < 0.05).  Similarly preterm labour was also statistically significant, with lower rate in group utilizing antenatal care early (1%) as compared to the other group (8.2%)  (p value < 0.05).
Conclusion: Women of reproductive age need to recognize the importance of receiving early antenatal care in the army setup. Factors such as fear of invasive treatment, more faith in dai system, husband being away, living at far distance from hospital were hindering in early booking. Similarly lower socio-economic status and literacy rate of women also delays early utilization of this facility. By early booking, we can reduce the number of patients reporting with complications especially anemia and preterm labour and thus reducing the need of hospital admission and cost on many expensive medicines.