Status Quo And Influencing Factors Study On Intrapartum And Postpartum Care For Rural Women In Rongchang County

Objective:To know the status quo of intrapartum and postpartum care for rural women in Chongqing Rongchang County, and to analyze the factors influencing intrapartum and postpartum care utilization of rural women. To evaluate intervention measures'effect by comparing differences of intrapartum and postpartum care utilization between intervention groups and control group, and to propose suggestions for improving intrapartum and postpartum care service utilization.Methods: The study adopted quantitative methods. 700 Chongqing Rongchang rural women delivered in April 2008 to December were selected into study based on stratified cluster sampling. Four aspects were investigated by questionaire, which including general family information, history of pregnant and delivery and pregnant care, intrapartum care, and postpartum visits.Results: (1) Hospital delivery rate was 98.42% in Rongchang, home delivery rate was 1.15%, Cesarean section rate was 43.20%, postpartum visit rate was 63.44%, 3 times or more postpartum visits rate was 26.28%, and systematic management rate was 16.73%. (2) The cost of hospital delivery was expensive, the median was 2000 Yuan, vaginal delivery was 1500 Yuan, and cesarean section is 2500 Yuan. NCMS participate rate was 71.24%. Women who participated NCMS had been reimbursed were 46.74%. Violating the family planning policy accounted for 70.43% of the reason for having no reimbursement. (3) Factors influencing hospital delivery rate were husband's age, number of existing children, and woman's age. Factors influencing Cesarean section rate were whether violated the family planning policy, education of the woman, times of pregnancy, and time to the nearest THC. Factors influencing postpartum visit rate were occupation of woman, number of existing children, and time to the nearest THC. Factors influencing 3 times or more postpartum visits rate were occupation of woman and times of pregnancy. (4) Intervention measures were Ineffective, but the medical knowledge and clinical skills training for township and village doctors can improve 3 times or more postpartum visits rate of rural women.Conclusions: The intrapartum and postpartum care indexes of Rongchang County improved markedly, but some indexes are still below the standard of rural areas should reach, which promulgated by the Ministry of Health, so there is much room for improvement. In order to improve the capacity of rural women to utilize intrapartum and postpartum care services, we should increase funding for rural public health, and improve maternal and child health care network construction, and to enhance medical technology and quality of service of THC so that more social resources and health resources gathered in THC, and to strengthen THC's role of intrapartum and postpartum care services provider for pregnant and prenatal women in rural areas. At the same time, we should strengthen health education and propaganda to the special groups, which include older pregnant women, pregnant women with many children, and floating population,to boost up pregnant women and their families'initiative to seek pregnant and prenatal care. Meanwhile we should reinforce systematic management for them, so that we can improve their intrapartum and postpartum care services utilization. At last, the health department and the family planning department should step up cooperation with each other, and make good use of resources and information, to construct maternal and child health care network of rural women jointly, and to improve the maternal reproductive health care level of women who violate the family policy, and to improve maternal health care together.