Effects of dehumanized childbirth on utilization of Skilled Birth Attendance in Kenya

Background
Dehumanization of childbirth is one major factor deterring pregnant women from seeking facility based delivery contributing to stagnating indicators of MDG 4 and 5 including skilled birth attendance (SBA) rates.
Methods
A qualitative study was conducted in Kenya across 5 districts through 60 case narratives with women who had delivered in the last one year at a health facility or at home. This study sought to explore the determinants of place of delivery and explore the effect of dehumanized child birth experiences on utilization of SBA.
Results
The key determinants of place of delivery was perceptions of respectful care accorded, availability of money to finance health care, fear of HIV testing and socio-cultural beliefs associated with childbirth. Dehumanized childbirth was associated with use of unskilled birth attendance mainly untrained traditional birth attendants. TBAs were often sought as alternatives for provision of delivery services because they have cheaper negotiable prices; they are polite and respectful, did not detain mothers, and offered more friendly services.
Dehumanized treatment during child birth is a deterrent to SBA and service improvements addressing this aspect of care are likely to have a positive impact on health seeking behavior through encouraging utilization of SBA.