Status, Associated Factors, and Reasons for Bypassing the Childbirth Center among Postpartum Women in the Dire Dawa Administration, Ethiopia: a Mixed Study

Background: Childbirth in nearby health facilities is an important strategy to reduce complications for mothers and newborns, including death. Bypassing nearby birthing health facilities is common in developing countries. However, there is a lack of data in the study area on the extent and reasons for bypassing. Therefore, this study was aimed at assessing these gaps. Methods: A facility-based mixed study was conducted at the Dire Dawa administration, Ethiopia, from December 1–30, 2022. Simple random (quantitative) and purposive (qualitative) sampling techniques were used. Data were collected through interviews using structured (quantitative) and semi-structured (qualitative) questionnaires. Quantitative data were entered and cleaned by Epi DATA (Version 3.1) and analyzed using SPSS (Version 22). A P-value of 0.05 or less at multivariate with 95% confidence intervals was considered statistically significant. Qualitative data were thematically analyzed. Results: 635 participants (quantitative) and twelve for the qualitative analysis were included. The overall bypass was 30.9%. Higher age group (AOR = 2.34, 95% CI: 1.43–3.82), rural residence (AOR = 1.89, 95% CI: 1.11-3.22), no formal education (AOR = 2.26, 95% CI: 1.23–4.16), obstetric care needs during antenatal care (AOR = 2.37, 95% CI: 1.33–4.22), and health professionals’ behavior (AOR = 3.10, 95% CI: 1.99–4.78) were associated with a higher likelihood of bypassing. Conclusion: Bypassing childbirth health facilities was moderate. Perception, health professionals, and facility-related factors were the main identified themes in the qualitative results. Stakeholders recommended improving obstetrics services and researchers conducting additional research.