Birthing centres in Nepal: Recent developments, obstacles and opportunities.

Abstract

Background: Establishing and promoting birthing centers (BCs) can be one strategy to increase access to emergency obstetric care and skilled attendants at birth, to avert many maternal deaths. BCs are a component of local health service delivery, whereby midwives (or health care professionals with midwifery competencies) provide maternity services to generally healthy women with uncomplicated pregnancies, mostly in the community setting. Methods: A literature review was carried out involving searches and appraisals of relevant literature on birthing centers in Nepal, South Asia, and other similar settings. Findings//Conclusion: In Nepal, midwife-led care in BCs was found to be appropriate for pregnant women, with no complications, for giving birth. BCs have the potential to improve both (a) the institutional delivery rate and (b) the proportion of births that benefit from the presence of a skilled birth attendant (SBA). However, accessibility, socio-demographic characteristics, and cultural factors act as barriers to pregnant women attending birthing centres and hospital facilities. Moreover, there is an increasing trend of bypassing BCs to give birth in hospitals. The increase in facility-based births requires more monitoring of the quality of care provided.