abstract: 'Background: Pakistan has one of the highest rates of maternal and

  neonatal mortality in the world. It is assumed that employed mothers in

  paid work will be more empowered to opt for safer institutional

  deliveries. There is a need to understand the predictors of home

  deliveries in order to plan policies to encourage institutional

  deliveries in the region.

  Methods: The study aimed to ascertain the predictors for home deliveries

  among mothers employed in paid work in Pakistan. Data analysis is based

  on secondary data taken from the Pakistan Demographic Health Survey

  2012-13. Bivariate and multivariate logistic regression models were

  conducted.

  Results: The findings show that the majority (53.6\%) of employed

  mothers in Pakistan give birth at home. Employed mothers in paid work

  with the following characteristics had higher chances for delivering at

  home: (i) women from rural areas (AOR 1.26; 95\% CI: 0.94-1.71), or

  specific regions within Pakistan, (ii) those occupied in unskilled work

  (AOR 2.61; 95\% CI: 1.76-3.88), (iii) women married to uneducated (AOR

  1.70; 95\% CI: 1.08-2.66), unemployed (AOR 1.69; 95\% CI: 1.21-2.35), or

  unskilled men (AOR 2.02; 95\% CI: 1.49-2.72), (iv) women with more than

  7 children (AOR 1.57; 95\% CI: 1.05-2.35), (v) women who are unable in

  the prenatal period to have an institutional check-up (AOR 4.84; 95\%

  CI: 3.53-6.65), take assistance from a physician (AOR 3.98; 95\% CI:

  3.03-5.20), have a blood analysis (AOR 2.63; 95\% CI: 1.95-3.57), urine

  analysis (AOR 2.48; 95\% CI: 1.84-3.33) or taken iron tablets (AOR 2.64;

  95\% CI: 2.06-3.38), and (vi) are unable to make autonomous decisions

  with regard to spending their earnings (AOR 1.82; 95\% CI: 1.27-2.59)

  and healthcare (AOR 1.12; 95\% CI: 0.75-1.65).

  Conclusions: Greater efforts by the central and provincial state bodies

  are needed to encourage institutional deliveries and institutional

  access, quality and cost. Maternal and paternal benefits are needed for

  workers in both the formal and informal sectors of the economy. Finally,

  cultural change, through education, media and religious authorities, is

  necessary to support institutional deliveries and formal sector paid

  employment and out of home work opportunities for mothers of Pakistan.'
affiliation: 'Fischer, F (Corresponding Author), Bielefeld Univ, Sch Publ Hlth, Dept
  Publ Hlth Med, Bielefeld, Germany.

  Jafree, Sara Rizvi, Forman Christian Coll, Dept Sociol, Lahore, Pakistan.

  Zakar, Rubeena, Univ Punjab, Inst Social \& Cultural Studies, Lahore, Pakistan.

  Mustafa, Mudasir, Univ Punjab, Dept Sociol, Inst Social \& Cultural Studies, Lahore,
  Pakistan.

  Fischer, Florian, Bielefeld Univ, Sch Publ Hlth, Dept Publ Hlth Med, Bielefeld,
  Germany.'
article-number: '316'
author: Jafree, Sara Rizvi and Zakar, Rubeena and Mustafa, Mudasir and Fischer, Florian
author-email: f.fischer@uni.bielefeld.de
author_list:
- family: Jafree
  given: Sara Rizvi
- family: Zakar
  given: Rubeena
- family: Mustafa
  given: Mudasir
- family: Fischer
  given: Florian
da: '2023-09-28'
doi: 10.1186/s12884-018-1945-4
files: []
issn: 1471-2393
journal: BMC PREGNANCY AND CHILDBIRTH
keywords: Mothers; Paid work; Employment; Delivery; Pakistan
keywords-plus: 'ECONOMICALLY DISADVANTAGED MIGRANTS; MATERNAL HEALTH; SYSTEMATIC

  ANALYSIS; BIRTH; CARE; MORTALITY; OUTCOMES; NEWBORN; TRENDS;

  DETERMINANTS'
language: English
month: AUG 3
number-of-cited-references: '59'
orcid-numbers: 'Zakar, Rubeena/0000-0001-9546-3742

  Mustafa, Mudasir/0000-0002-4870-9014

  Fischer, Florian/0000-0002-4388-1245'
papis_id: d33502058d352de117cf077a096d4300
ref: Jafree2018mothersemployed
researcherid-numbers: 'Zakar, Rubeena/HTR-8354-2023

  Mustafa, Mudasir/AAG-9977-2020

  Mustafa, Mudasir/AGV-1350-2022

  Fischer, Florian/F-9003-2016'
times-cited: '8'
title: Mothers employed in paid work and their predictors for home delivery in Pakistan
type: Article
unique-id: WOS:000440852800004
usage-count-last-180-days: '0'
usage-count-since-2013: '7'
volume: '18'
web-of-science-categories: Obstetrics \& Gynecology
year: '2018'