A new study analyzing nearly 26,000 births at Moi Teaching and Referral Hospital (MTRH) between September 2020 and November 2023 has revealed surprising findings: delivering at night or on weekends might actually result in better outcomes for mothers and their babies.
Challenging Prevailing Assumptions
Contrary to global concerns about reduced staffing during off-peak hours, researchers discovered an 8% lower risk of adverse maternal and neonatal outcomes for births during nighttime or weekends. Preterm births, low birth weight cases, and emergency caesarean deliveries were also less frequent during these periods.
“We found a slight protective association between weekend deliveries and improved maternal and birth outcomes,” the study authors noted.
The research team included experts from Moi University, MTRH, and several U.S.-based institutions, including the University of Washington, University of Alabama at Birmingham, and Indiana University. Their findings, published in BMC Pregnancy and Childbirth, challenge assumptions about the risks of off-hour deliveries.
What Makes Nighttime Safer?
At MTRH, night shifts may benefit from the presence of experienced and focused healthcare professionals, with fewer administrative distractions. Additionally, fewer non-urgent procedures such as medically induced labor or elective surgeries might contribute to the better outcomes observed during these hours.
Key Predictors of Complications
While timing played a modest role, other factors had a more significant impact on maternal and neonatal outcomes.
- Maternal Transfers: Women transferred to MTRH during labor faced a 42% higher risk of maternal complications, a 28% higher likelihood of birth complications, and more than double the risk of neonatal death compared to those who started care at the hospital.
- Age and Health Conditions: Younger mothers (under 24) experienced better outcomes, while those over 35 faced higher risks. Pre-existing conditions such as preeclampsia, anemia, or prior C-sections were also linked to complications.
Broader Implications for Maternal Health in Kenya
Kenya’s maternal mortality rate stands at 355 deaths per 100,000 live births, translating to nearly 5,000 maternal deaths annually. More than 80% of these deaths are attributed to poor-quality care.
The study highlights the critical need to strengthen maternity care nationwide, particularly in rural and lower-tier facilities where staffing and resources may not match those at MTRH.
Limitations and Recommendations
The researchers emphasized caution in interpreting these findings, as the results may not apply to less-resourced hospitals. They also noted limitations in their study, such as the inability to account for staffing levels or distinguish between spontaneous and induced labor.
Still, the findings raise important questions about how healthcare systems can optimize maternity care at all hours.
To reduce neonatal deaths, which stood at 21 per 1,000 live births in 2022, Kenya must address disparities in maternity care, particularly in rural areas. The study’s findings offer a foundation for exploring how staffing patterns, resource allocation, and operational practices can improve maternal and neonatal health outcomes
