80% of women in Laos choose home birth — with only 20% attended by “skilled health personnel” — over hopsital birth despite maternal mortality rate of 400 per 100,000 live births.
Cost — hospital charges (50-80% hospital income from user fees/sale of pharmacueticals), transportation, lost labor (mother and family accompanying)
Distance to hospital — increases cost, makes hard for family to be present
Cultural practices ignored –Family must be present, trained health workers don’t respect traditional practices, no baths/saunas, no “rest over fire,” burial of placenta at home
Negative aspects of hospital care — Embarrassing birth position (high bed, on back), episiotomy, lack of privacy, rise in (costly) C-sections
Influence of mothers/grandmothers — They delivered at home
The author, Dr. Donald Marsden, concludes:
However, it is obvious that until many of the social and cultural issues are addressed, homebirth is likely to be favoured by a large proportion of the population into the foreseeable future, despite the manifold dangers.
Read the full article here: http://www.ranzcog.edu.au/publications/oandg-magazine/doc_view/774-48-homebirth-in-laos.html