Obstetric Complications in Two Major Urban Maternal and Child Clinics in Mogadishu Somalia: A Cross Sectional Study on Prevalence and Associated Factors

Abstract

Somalia has the highest adult lifetime risk of maternal mortality of 1 in 18. Few pregnant women visit the antenatal care and have access emergency obstetric care services to detect and handle complications at childbirth. We assessed the cases of obstetric complications and associated factors in two major maternal and child clinic in urban areas of Mogadishu Somalia. This cross sectional study was conducted between 2015 and 2016 amongwomen who had given birth at Banadir Maternity and Children Hospital and SOS Maternal and Child Clinic in Mogadishu Somalia. Participants’ information was collected through interviews and health records. Data were analyzed using bivariate and multivariable logistic regression to determine factors associated with being prepared, with statistically significant level at p < 0.05. A total of 203 out of 385 (52.7%) women had obstetric complications. This included 30% severe bleeding, 29.6% obstructed labor, 23.6% hypertensive disorder and 14.3% cases of sepsis. Employment status (OR 0.6, 95% CI 0.4 to 0.9) monthly income (OR 1.7, 95% CI 1.1 to 3.2), antenatal care attendance (OR 0.7, 95% CI 0.5 to 0.9), ANC initiation in the first trimester (OR 0.7, 95% CI 0.5 to 0.9), home delivery assisted by Traditional Birth Attendance (OR 1.7, 95% CI 1.7 to 2.4), worsening of past medical condition preceding the current birth (OR 1.6, 95% CI 1.2 to 2.3), current pregnancy termination (OR 1.9, 95% CI 1.1 to 3.4), vaginal delivery (OR 0.5, 95% CI 0.3 to 0.6), delivery assisted by a nurse (OR 0.4, 95% CI 0.3 to 0.6) were associated with obstetric complication. The high proportion of obstetric complication especially hemorrhage among women in Mogadishu Somalia, requires that women be monitored closely during pregnancy to reduce complications and death, in the absence of medical interventions. Economic empowerment, improved awareness of ANC, training of TBA would be key in reducing the obstetric complication in this region