Clinical Audit of Birth Before Arrival at a Midwife Obstetric Unit from South Africa during 2018 to 2022

Given its link to maternal and perinatal morbidity and mortality, birth before arrival (BBA) is a public health concern. The purpose of this study was to evaluate the prevalence, trends, outcomes, and contributing factors of BBA among women who gave birth in a South African midwife obstetric unit between 2018 and 2022. A cross-sectional descriptive analysis was carried out among women who gave birth and saw a BBA right away using data from the labor ward birth registration. Variables with a p value of less than 0.05 were deemed significant, and descriptive statistics like frequency, cross table analysis, and binary logistic regression analysis were calculated. 4.8% of people had BBA (95% CI: 4.4, 4.9). Between 2018 and 2022, BBA decreased from 5.2% to 3.8% (p= 0.021). Women with nil parity (OR= 0.054, 95% CI; 0.021:0.140, p < 0.001), parity 1–2 (OR= 0.164, 95% CI; 0.076:0.350, p < 0.001), and parity 3–4 (OR= 0.27, 95% CI; 0.12:0.60, p = 0.001) were the variables linked to BBA in logistic regression. Comparing women who received ANC at KCHC to those who received ANC at another medical facility, the former had a lower OR of 0.63 (95%CI; 0.44:0.91, p = 0.014). Conversely, compared to women who had nine or more antenatal care (ANC) visits, those who had none (ANC visit 0 or never scheduled for ANC) had a higher OR of 3.41 (95%CI; 1.205:9.66, p= 0.021). Preterm birth (PTB) had an OR of 1.53 (95% CI: 1.05:2.22, p= 0.024), while Low birth weight (LBW) had an OR of 2.41 (95% CI: 1.53:3.79, p < 0.001). According to the survey, the prevalence of BBA is trending downward. These results demonstrated how crucial early ANC scheduling and sufficient prenatal care are to enhancing pregnancy outcomes.