Association between non-institutional birth and antenatal care in rural areas of Peru

Background/Aims In low- and middle-income countries, home births and non-institutional births can be associated with higher risk of mortality and morbidity. The aim of this study was to evaluate the association between the content and quality of antenatal care given to women in rural areas of Peru and the location of their child's birth. Methods An observational study was conducted using secondary data from a national survey in Peru for 2022. The association between the content of antenatal care and home births was assessed using a generalised linear model and prevalence ratios were calculated. Results A higher prevalence of home birth was observed if one or more aspects of care (P<0.001), examinations (P=0.008) or counselling (P<0.001) were not met. Similarly, the prevalence of home births was higher among women who attended <6 antenatal visits (P<0.001) and if the care was provided by someone other than a qualified healthcare professional (P<0.001). Conclusions The content and quality of prenatal care may influence the likelihood of a woman having a home birth, which in the Peruvian context may result in a higher level of morbidity and mortality. Barriers to healthcare services persist in rural areas. Implications for practice It is the responsibility of the healthcare system to ensure adequate provision of antenatal care in rural areas. Future studies should assess deficiencies in healthcare services to improve antenatal care and reduce the risks associated with non-institutional birth.