Introduction: To reduce maternal mortality, many countries encourage women to deliver in health facilities, where complications can be handled more effectively. In Liberia, attempted home deliveries accounted for about 10% of maternal deaths in 2016/2017. It is therefore necessary to identify the factors influencing maternal choice of delivery site in Liberia. This study seeks to determine the preferred choice of delivery site and factors associated with the choice in Liberia.
Methods: A cross-sectional design was used to study 630 women of reproductive age who had given birth less than one year before the survey. A two-stage cluster sampling method using a modified WHO 30 by 7 approach was used to select 30 communities (clusters) and 21 women within each cluster as respondents. A pre-tested interviewer-administered semi-structured questionnaire was used.
Results: The mean age of study participants was 26 ± 6.8 years, with 84% between 18 and 35 years. The median number of births per woman was 5 (1 – 12). The proportion of mothers who preferred health facility over home delivery as their original choice of delivery site was 86%, four times greater than those who preferred home over health-facility delivery (22%), (POR= 3.8, 95% CI: 1.6 – 9.1). Mothers who attended < 4 antenatal visits were 30% less likely to originally choose health facilities as their preferred delivery site compared to those who had 4 or more antenatal visits (60% vs 86%) (POR= 0.7, 95% CI: 0.5 – 0.9). Women living in communities where the leaders had instituted sanctions against women who deliver at home were 10% more likely to choose health facility delivery, compared to those whose communities had no sanctions (POR= 1.1, 95% CI: 1.0 – 1.2).
Conclusion: Health-facility deliveries are preferred to home deliveries. County Health Teams should sensitize the community on the benefits of delivering at the health facility and increase community involvement (local authorities).