BACKGROUND: The influence of socio-cultural factors on
institutional birth is not sufficiently documented in Ethiopia.
Thus, this study explores socio-cultural beliefs and practices
during childbirth and its influences on the utilization of
institutional delivery services.
METHODS: A qualitative study was conducted in three regions of
Ethiopia through eight focus group discussions (with women) and
thirty in-depth interviews with key informants which included
health workers, community volunteers, and leaders. The data were
RESULTS: The study identified six overarching socio-cultural
factors influencing institutional birth in the study communities.
The high preference for traditional birth attendants (TBAs) and
home as it is intergenerational culture and suitable for privacy are
among the factors. Correspondingly, culturally unacceptable birth
practices at health facilities (such as birth position, physical
assessment, delivery coach) and inconvenience of health facility
setting to practice traditional birth rituals such as newborn
welcoming ceremony made women avoid health facility birth. On
the other hand, misperceptions and worries on medical
interventions such as episiotomy, combined with mistreatment
from health workers, and lack of parent engagement in delivery
process discouraged women from seeking institutional birth. The
provision of delivery service by male health workers was cited as a
social taboo and against communities' belief system which
prohibited women from giving birth at a health facility.