RESULTS
The total number of women giving birth at Taiz Houbane MCH Hospital was 1014 in August 2017 and 428 in November 2017, of which 11% (108/1014) and 19% (82/428) were delivered by caesarean section, respectively. By randomly selecting 250 women with vaginal births from each month to assess quality of care further, 25% of women in August were included for the in-depth analysis and 58% in November.
Background characteristics of labouring women were compared between the 250 women with vaginal birth in each period selected for in-depth analysis as well as for all the caesarean sections. There were no significant differences between the subgroups of women with vaginal births and caesarean sections, and they are here presented as one group for each study month. Proportion of women attending a minimum of one ANC visit was lower in the low-volume month compared with the high-volume month (44% (137/358) versus 52% (152/332), p=0.034). No other indicator of background characteristics showed significant difference. In brief, the total rate of pre-existing obstetrical risk factors in current pregnancy was 34% (236/690) among all included women in both study months. Among all, 36% (246/690) were nulliparous, 15% (105/690) were para five or more, and 8% (54/690) were below the age of 20 years. Among multiparous women, 24% (107/444) had previously suffered from the death of a child. Of all women, 7% (49/690) were admitted after failed trial of labour at home. Among these, where information on pre-hospital augmentation was available, 88% (30/34) had received unregulated oxytocin or misoprostol at home (Table 1).