1.4 Socio-economic factors influencing child birth places
Various social groups in Sub-Saharan Africa practice different lifestyles, which may differ in some aspects but are almost similar in contexts . Studies have shown that maternal procedures in Sub-Saharan Africa are prone to crisis as a result of multiple social and economic factors. These social factors affect the child practices among women of child bearing age in most countries in these parts of Africa . Social factors are experiences which influence the way an individual thinks, lifestyle and attitude. The common social factors which have affected childbirth include: educational background, accessibility to good medical care and child birth facilities, environmental and climate of the individuals’ residence, societal/personal lifestyle adopted by individuals etc.
Nigeria consists of numerous social groups and each of these groups has their own common interests guided by lots of factors. The social factors that commonly influence childbirth practices in Nigeria are associated with increased maternal or pre-natal morbidity . One of the commonest childbirth practices that can be associated with social factors among Nigerian women is the practice of home births.
In Madagali which is located in North-Eastern Nigeria, a significant number of home births take place and are supervised by unskilled individuals. These home births account for high mortality rate in the Northern part of the country . In addition to home births, women in this part of the country face poor education and low socio-economic status in their societies. Because of this, lack of proper education has led these women to believe that home birth is safer for them. Also, these women participate mainly in house chores, farming and petty trades. Hence, they do not have the financial capabilities to pay for hospital births under the supervision of skilled personnel . This has led many of them to settle for home births.
The marital status of the women of childbearing age in Sub-Saharan Africa is another significant social factor that influences their child birth practices and the delivery places they may choose. For instance, single or divorced women may be able to make decisions by themselves, without any man (husband) influencing their decisions on their choice of birth methods, as compared to married women .
Another social factor which influences child birth in Sub-Saharan countries like Nigeria, Niger and Benin Republic is that women are exposed to childbirth within short intervals, due to their societal demands to satisfy the quests of the men to have large family size . Many women now conceive and give birth to numerous children within short intervals. This has lead to an increase in infant morbidity and mortality in these regions . In Lagos State, Nigeria, the childbearing women of Ogu speaking people of Badagry often give birth to children within short intervals . This implies that men play a huge role to the conditions of the pregnant women in the community. This is perceived as a means of satisfying their husbands’ quest for large family size, which may not be unconnected with the effect of decision making in the family.
The study by Ezeama & Ezeamah suggested that malnutrition is another social factor influencing the childbirth practices among the women; the findings from this study showed that some pregnant women are malnourished by their diets because they eat only what are obtainable in their community . This can also be associated with lack of education regarding antenatal and maternal care. If these women are exposed to enlightenment from skilled professionals, they would be able to take food that would improve their conditions during pregnancy and child delivery.
In the Southern part of the country, the lifestyles of the individuals also influence childbirth practices. For instance, the residents of riverine areas of Bayelsa and some parts of Rivers state, practice home births because they have adopted it as their lifestyle. It is easier to deliver at home than cross the river on a boat during labor to a nearby hospital in such environments .
One of the major causes of maternal mortality among women of child bearing age is the lack of adequate access to skilled personnel . In Sub-Saharan African, many women do not have access to skilled personnel during childbirth . Globally, existing literature points to various social and economic factors that have been attributed to low access to health facilities and skilled personnel  by expectant women. In Ethiopia, although there has been tremendous improvement in terms of providing adequate maternal healthcare, maternal mortality is recorded to be among the highest in the world with 412 deaths per 100,000 live births . The study by Bukar and Jauro, has also shown that in low-income countries, the major cause of maternal mortality is unskilled birth attendance . It is necessary to improve skilled care at birth in order to reduce maternal death. Records have shown that a 10% increase in skilled birth attendance corresponds to 5% reduction in maternal deaths . Studies have shown that maternal procedures in Sub-Saharan Africa are prone to crisis as a result of multiple social and economic factors. These social factors such as occupation and education affect the child practices among women of child bearing age in most countries in these parts of Africa .
The effects of education are assumed to predominantly flow through women’s cognitive skills, material resources, and autonomy, which should in turn affect their maternal practices and healthcare use, and ultimately their health outcomes . Education should have a positive effect on women’s cognitive skills especially literacy, should benefit maternal health by increasing women’s ability to seek information about their own health and by assuring that women are better able to follow written instructions. Education reduces the effect of patriarchal system; men have traditionally been the economic providers for their families and the ones to determine how household resources are spent, However, if education increases women’s employment or earnings, then women’s greater ability to provide for their families may grant them more decision-making power within the home, including decisions about delivering in hospitals and other formal healthcare centers as opposed to in one’s home, should improve postnatal health by reducing the risk of postpartum infection, and providing skilled birth attendants who are equipped to address complications during delivery .
Education enhances health-seeking behaviors, and this may lead to the prevention and early detection of complications during pregnancy and childbirth and reduce the risk of death when complications arise but few studies have been able to determine whether women’s education has a causal effect or whether the link between education and maternal health .
Financial capability directly affect whether women can actually reach a facility for delivery. The anticipation of high costs will affect whether a decision for a facility delivery is made in the first place. Women who are working and earning money may be able to save and decide to spend it on a facility delivery. However, in many settings, women either do not earn money for their work or do not control what they earn. On the other hand, working may be poverty induced and indicate recourse constraints which would make working mother less likely to use health service for delivery . For example, in two southern Indian States and in Nepal, working women, may signify that working is poverty induced . A study also found an interesting interaction that favor employed women gainfully among those living more than one hour travel time from a health centre, while employment status does not play a role among those within one hour travel time, and this could be due to employed women being better equipped to overcome access barrier including transportation costs or female mobility limitation .
Therefore, this study is aimed to explore the significance of the influence of some socio-economic factors on choices of childbirth places among women in Oyigbo local government area of Rivers State, Nigeria and the significance of the influence of income and educational status on choices of childbirth places among women in Oyigbo local government area of Rivers State, Nigeria.