IJOMAHIP Published Article Details

Abstract Non-institutional delivery remains a preventable source of maternal and neonatal morbidity in the Philippines. Grand multiparity accelerates labor progression and is a recognized risk factor for delivery outside healthcare facilities. The labor-pattern correlates of non-institutional delivery at a Philippine tertiary emergency department have not been systematically characterized. Methods. A cross-sectional analytical study was conducted at Zamboanga City Medical Center (ZCMC), a Department of Health-retained tertiary government hospital in Zamboanga City, Philippines, from January 1, 2023, to December 31, 2024, using emergency room (ER) records and structured telephone interviews. Eligible participants were pregnant women discharged during the latent phase of labor who subsequently delivered outside the facility. The primary outcome was non-institutional delivery. Bivariate associations were assessed using Fisher's exact test, with odds ratios (OR) and 95% confidence intervals (CI). This report follows the STROBE guideline for cross-sectional studies. Results. Of 1,336 classified records, 41 (3.1%) were non-institutional deliveries. Grand multiparity was significantly associated with increased odds of non-institutional delivery (OR 3.76, 95% CI 1.41–10.03; p = 0.018), while nulliparity was associated with reduced odds (OR 0.36, 95% CI 0.17–0.74; p = 0.004). Maternal age of 35 years or older (OR 1.16; p = 0.796) and advanced cervical dilation at discharge (OR 0.35; p = 0.317) were not significantly associated with non-institutional delivery. Mean age of women with non-institutional delivery was 26.1 ± 7.3 years, and teenagers comprised 19.5% of this group. Conclusion and Implications. Parity, not maternal age or cervical dilation at discharge, was the primary correlate of non-institutional delivery in this setting. These findings support consideration of parity-stratified triage protocols, investment in ER labor documentation, and community-level rapid labor recognition programs targeting grand multiparous women, pending confirmation in larger, multivariable-adjusted, multi-center studies.