• A C Moran, T Wahed, and K Afsana.
• Reproductive Health Unit, Public Health Sciences Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh. allisynmoran@gmail.com
• BJOG. 2010 Dec 1; 117 (13): 1608-15.

ObjectiveIn Bangladesh, the majority of women give birth at home. There is anecdotal evidence that unqualified allopathic practitioners (UAPs) administer oxytocin at home births to augment labour pain. The objective is to explore the use of oxytocin to augment labour pain during home births in an urban slum in Dhaka, Bangladesh.DesignCross-sectional survey.SettingKamrangirChar slum, Dhaka, Bangladesh.PopulationMarried women with a home birth or who experienced labour at home in the 6 months prior to the survey (n = 463) were interviewed. Twenty-seven UAPs were interviewed to validate women's responses.MethodsBivariate and multivariate logistic regressions were used to identify significant predictors of oxytocin use.Main Outcome MeasuresReported use of oxytocin to augment labour pain.ResultsForty-six percent of women reported using medicine or other treatments to augment labour pain, 131 of whom reported using oxytocin (28% of total). Traditional birth attendants were the predominant decision-makers of when to use oxytocin. The medication was provided by a UAP who administered the drug via saline infusion or intramuscular injection. Higher education, lower parity, reported long labour (more than 12 hours), and knowledge of and positive attitudes towards oxytocin were significantly associated with oxytocin use after controlling for other factors. In the validation exercise, there was agreement about the use of oxytocin to augment labour in 22 of 27 cases (82%).ConclusionsAbout one-third of women used oxytocin to augment labour pain. This practice has implications for health education as well as future research to assess the impact on adverse maternal and neonatal outcomes.© 2010 The Authors Journal compilation © RCOG 2010 BJOG An International Journal of Obstetrics and Gynaecology.

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