Assessment of Factors Influencing Pregnant Mothers' Decision to Give Birth Outside Booked Antenatal Care Facilities in Ikwo Lga, Ebonyi State

Background: In spite of the availability of antenatal care (ANC), many women in resource-limited settings opt for delivery outside their registered facilities. This study assessed the factors influencing pregnant mothers’ decisions to give birth outside booked ANC facilities in Ikwo Local Government Area, Ebonyi State, Nigeria. Methods: A community-based cross-sectional study was conducted among 400 mothers of reproductive age. A multistage sampling technique, involving simple random and convenience sampling, was utilized. A standardized interviewer-administered questionnaire was used to gather data, which was then analyzed using Chi-square (X2) tests and descriptive statistics to look for relationships between sociodemographic factors and delivery sites. Results: The result shows that average age of respondents was 31 years, with a mean parity of 4; 66% were married, and the majority possessed formal education. Most participants resided in rural areas (76.25%) and were predominantly farmers with a mean annual income of N264,287.50K. Key drivers for non-facility delivery included family preference for home birth (65%), fear of Cesarean Section (60%), and previous delivery experiences. Significant associations were found between delivery outside registered facilities and parity (X2= 19.53), place of residence (X2= 22.46), income (X2= 129.46), and education level (X2= 57.91). High Cramer’s V indices (ranging from 0.621 to 0.852) indicated a very strong relationship between these socio-demographic factors and the decision to deliver outside booked facilities (p < 0.05). Conclusion: Socioeconomic and demographic characteristics, specifically parity, income, rurality, and education, critically influence the choice of delivery site. Traditional family influence and fear of surgical intervention remain significant barriers to facility-based delivery. Recommendations: There is an urgent need to enhance health literacy through targeted community workshops and accessible information platforms. Efforts should focus on demystifying safe birthing practices and emphasizing the risks of unsupervised deliveries to improve maternal health outcomes in Ikwo LGA.