Prevalence and factors associated with postpartum morbidities among muslim married mothers during postpartum period in squatter settlements of Karachi, Pakistani
Date of Award
Master of Science in Epidemiology & Biostatistics (MSc Epidemiology & Biostats)
Community Health Sciences
Pregnancy and childbirth related complications are among the leading causes of morbidity and mortality in women of reproductive age in developing countries. It is estimated that nearly % million deaths occur annually during the antepartum, partum, and postpartum period in South Asia. Despite global efforts to improve maternal and child health, the focus still remains largely on the newborn rather than the mother. Even if a mother safely crossed the antepartum and partum period, she remains at risk during the postpartum period. Postpartum morbidities can go unrecognized by the family as well as the mother herself. For some, cultural traditions may limit their mobility and freedom to access health care facilities. For others, these morbidities are further aggravated in the presence of traditional practices and beliefs that the mother has to adhere to. A community-based cross-sectional study was undertaken to estimate the prevalence of postpartum morbidities among Muslim women residing in urban squatter settlements as well as to identify the factors associated with their seeking health care during the postpartum period. A secondary objective of the study was to identify factors associated with postpartum hemorrhage and vaginal infection among the same study subjects. The study was conducted in five squatter settlements of Karachi during July-December 2000. A total of 525 mothers who were between 42-56 day's post-delivery were identified through existing surveillance systems. Trained staff collected information using a pre-tested, structured questionnaire in Urdu. The final multivariate model of our study indicated that a mother not having family permission to visit a clinic (aOR= 8.7; 95% CI 1.2, 64.0) as well as a mother having no formal education (aOR= 1 .6; 95% CI: 1.1, 1.6) were associated with a mother not seeking health care during her postpartum period. Other significant factors included the husband having no formal education (aOR=l .34:95Vo CI: 1.1, 1.6) and home delivery of the index pregnancy (aOR=l .6: (95Vo CI: 1.0, 2.6). The final multivariate model for perceived postpartum hemorrhage included longer duration of labour, older maternal age (aOR= 1.1: (95% CI: 1.0, 1.1) and restricted fluid intake (aOR= 2.1: (95Vo CI: 1 .1, 4.0). For perceived vaginal infection, our final model indicated that for vaginal infections, factors included use of unhygienic material to staunch the lochia (aOR= 2.6; 95% CI: 1 .0, 6.6), delivery conducted by non-medical personnel (aOR= 12.5; 95% Cl: 2.1, 71.6). Duration of labor was not found to be significantly associated with perceived vaginal infection. This study recommends long and short-term interventions. The short term includes the need for health education among mothers and entire community for the maintenance of hygiene, safe delivery through medical personnel and proper fluid intake during the postpartum period. In long-term interventions, there is a considerable need to educate the community regarding improvement in the mobility of mothers and female education. Further research need to identify the association of restricted fluid intake and intra-vaginal insertion with perceived postpartum hemorrhage and vaginal infection.
Ali, T. S. (2001). Prevalence and factors associated with postpartum morbidities among muslim married mothers during postpartum period in squatter settlements of Karachi, Pakistani (Unpublished doctoral thesis). Aga Khan University, Karachi, Pakistan.