home delivery practices among pregnant women in southeast of iran and associated factors after the implementation of the health transformation plan: a case-control study

Background: free-of-charge vaginal deliveries have been offered as part of the health transformation plan (htp) in iran, but still a high proportion of deliveries are occurring at home. this study aimed to investigate the reasons for home deliveries after the implementation of htp in southeast of iran.methods: this case-control study included women who gave birth at home between september 2015 and september 2016 for their last pregnancy; considered as cases (n=300), and women who delivered at a health facility (hospital or safe delivery posts), assigned to the control group (n= 600). data were collected during face to face interview using a 77-item semi-structured questionnaire. a multivariable logistic regression technique was used to identify independent predictors of home delivery.results: women who were worried about giving birth at a teaching hospital (or=1.9, 95% ci:1.3 -2.8), women with negative experiences in the previous delivery (or=1.6, 95% ci:1.0-2.4), illiterates (or=3.8, 95% ci: 2.0-7.4), individuals with primary/secondary education (or=2.3, 95% ci: 1.3 - 4.4), women with no health insurance (or=5.1, 95% ci: 3.5-7.4), if the decision on choosing the place of birth was made by the women alone (or=12.7, 95% ci: 7-22.8), women with financial constraints (or=1.7, 95% ci: 1.2-2.4), women with precipitate labour (or=2.4, 95% ci: 1.7-3.5) and women with fear of the hospital environment (or= 1.6, 95% ci: 1.1- 2.4) were more likely to deliver at home.conclusions: our findings highlight socio-economic and cultural barriers that need to be addressed to reduce home deliveries among the disadvantaged women.