Extramural births in the context of reproductive health in socially deprived and excluded populations

Abstract

In many developed countries, a home birth is still an alternative to a birth in a health facility. In Slovakia, extramural births tend to be associated with underprivileged and marginalized groups of the population. The large ethnic group of Romani people is one such group. Aim: The aim of this retrospective study was to examine extramural births in Rimavská Sobota, a small town in Southern Slovakia, in the context of the overall sexual and reproductive health of Romani. Methods: During the study period between 2009 and 2013, there were 48 registered births in the town outside a health facility. The results of the retrospective study were analyzed in terms of absolute and relative frequency. Relationship between the variables was investigated by the Pearson correlation coefficient and by the chi-square test. The strength of relationship was measured by Cramér's V coefficient. Results: Forty-four (91.7%) out of 48 extramural births involved Romani mothers, and 68.7% of them took counselling sessions irregularly or never. The mean age of mothers was 26.3 years, and 91.7% of them had no formal education. A strong indirect statistical relationship between counselling sessions and extramural births was demonstrated, as well as between the mother's age and an extramural birth. Conclusion: The findings suggest that awareness among socially deprived population groups of the risks and possible complications involved in giving birth outside a health facility is inadequate. The authors see a solution in the effective implementation of sexual and reproductive health education of young Romani women and a more comprehensive preparation on their part for childbirth.