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'