85% of women in rural Bangladesh want their husbands to attend the birth, according to a household survey of 1367 women. Only 45% of the women said that this had actually happened.

Similarly, 83% of them wanted their husbands to attend antenatal clinics, and 78% postnatal clinics. But actual attendance was much lower, 31% and 5% respectively.

The big difference between what women want and reality is seen only in relation to institutional care. At home, the difference is much less. 99% of women want support from their husbands with care at home (eating, reducing workload, taking proper rest, accessing health services) and 95% report getting it. 94% say they want help with newborn care and 90% report getting it. 90% want help with preparing for birth and for possible complications, and 65% report getting it.

The reasons women gave for husbands not being present at the birth included being busy with work (40% of women said this) and the men not thinking it important to attend the birth (30% of women). 10% of the women said the problem was that husbands are not allowed by the health service to attend.

The researchers recommend that programmes and initiatives should recognize “the many ways in which men are already involved and further allow women’s preferences to be realized by creating an enabling environment at home and in health facilities for husbands to participate in MNH care”.

In the survey, about half the women were under 25. 40% had completed primary schooling. Nearly all were Muslim.

81% of the women reported that decision making about seeking care was done by themselves alone or jointly with their husband. For newborn care, sole/joint decision making was 84% and for the decision to go to a health facility was 71%.

There was a strong link between women saying they wanted high involvement of their husbands and the actual extent involvement of their husbands. The more aspects of care women wanted their husbands to be involved in, the greater extent of the husbands’ actual involvement. Women who wanted no involvement reported hardly any of it. Causality could work both ways here: the women’s preference could be driving the husband’s involvement, or the husband’s willingness to be involved could be raising the women’s expectations. Or a third factor may drive both: for example, relationship quality could influence both expectations and reality.

Rahman AE, Perkis J, Sa;a, SS, Mhajabin S, Hossain AT, Mazumder T & Arifeen SEL (2020), What do women want? An analysis of preferences of women, involvement of men, and decision-making in maternal and newborn health care in rural Bangladesh, BMC Pregnancy and Childbirth 20

Header photo: DFID. Creative Commons.