Maternal autonomy and high-risk pregnancy in Bangladesh: the mediating influences of childbearing practices and antenata
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(2020) 20:555
RESEARCH ARTICLE
Open Access
Maternal autonomy and high-risk pregnancy in Bangladesh: the mediating influences of childbearing practices and antenatal care Sumaiya Abedin1* and Dharma Arunachalam2
Abstract Background: Maternal, infant and neonatal mortality rates are high in Bangladesh. Certain childbearing practices and poor utilisation of antenatal care services make Bangladeshi women more vulnerable to experience poor health during pregnancy and adverse pregnancy outcomes. Also, women in Bangladesh remain considerably subordinate to men in almost all aspects of their lives, from education and work opportunities to healthcare utilisation. This study investigates the severity of health complications during pregnancy in relation to women’s autonomy, and how childbearing practices and utilisation of antenatal care mediate this relationship. Methods: Data from the most recent Bangladesh Demographic and Health Survey (BDHS) is used in this study. Multinomial regression models (MLRM) are employed to examine the relationship between the outcome variable high risk pregnancy, and explanatory variables - women’s autonomy, childbearing practices and use of antenatal care. Results: In Bangladesh, about 41.5% of women experienced high-risk pregnancies involving multiple health complications. Findings showed that women’s autonomy in decision-making, freedom of movement and economic autonomy were significantly associated with high-risk pregnancies. However, women’s autonomy in physical mobility in particular did so only through the mediating factors of maternal childbearing practices and antenatal care. Specifically, both early and delayed childbearing and shorter birth interval increased the likelihood of high-risk (multiple complications) pregnancies by about 30% and 31% respectively, high parity increased the risk by 23% and use of antenatal care decreased it by 46%. Conclusions: The Women’s decision-making autonomy, freedom of movement and economic autonomy had significant effects on high-risk pregnancies. However, the effects were mediated by both maternal childbearing practices and use of antenatal care in a limited way. Policies and programmes aimed at improving pregnancy outcomes need to focus on all three sets of factors: women’s autonomy, childbearing practices and use of antenatal care. Keywords: Autonomy, Antenatal care, Childbearing practices, High-risk pregnancy, Mediating effect
* Correspondence: [email protected] 1 Department of Population Science, University of Rajshahi, Rajshahi, Bangladesh Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this articl
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