Birth practice patterns in urban slums of Dhaka, Bangladesh

This study describes the patterns of birth related practices amongst women from an urban slum population in Dhaka city during December 1988 to May 1989. A household census identified all resident women of childbearing age in Rajabazar ward of Dhaka city. Of the 1017 women so identified, 289 women who had given birth to their last child over the previous five years were randomly selected for interview using a structured interview schedule. To observe actual birth practices, sixteen women pregnant for six months or more at the time of the census were followed-up to the immediate post-natal period. Eight local traditional birth attendants (TBAs) were interviewed informally to obtain insights about birthing techniques. A case study for a typical `normal' delivery is presented and discussed. Infant mortality in the study area was estimated at 191 per 1000 live births which is higher than the national figure of 117 per 1000 live births. Less than 4% of all births were delivered in a hospital and 78% were delivered by the local TBAs. In 8% of deliveries, the women were unattended and in 11% they were assisted by a family member. A physician was present for only 3% of deliveries. Due to the high percentage of TBA assisted births, training of local TBAs in safe birth practices may effectively reduce neo-natal mortality in urban slum areas of Bangladesh. Additionally, study findings for these slum-dweller women indicate that adult education for women and schooling for girls could help reduce perinatal and infant mortality.