Healthcare Facility Accessibility and Cultural Childbirth Traditions as Determinants of Intrapartum Care Preferences among Mothers: An Explanatory Sequential Mixed-Methods Study

Cultural childbirth traditions and healthcare facility accessibility significantly influence mothers' preferences for intrapartum care, with culturally sensitive healthcare services serving as a vital factor in maternal healthcare utilization. This mixed-methods study examined the influence of cultural childbirth traditions and healthcare facility accessibility on mothers' preferences for intrapartum care in the Municipality of Sapad, Philippines. Using an explanatory sequential mixed-methods design, quantitative data were collected from 100 mothers selected through random sampling to assess cultural childbirth traditions, healthcare facility accessibility, and intrapartum care preferences. Subsequently, qualitative data were gathered from 10 mothers selected through purposive sampling to further explore and explain the quantitative findings, providing deeper insights into the factors influencing their intrapartum care preferences. Quantitative data were analyzed using descriptive and inferential statistical tools, while qualitative data underwent thematic analysis. Results showed clear evidence of cultural childbirth traditions in areas such as traditional birth practices, family influence, social networks, modesty, gender sensitivity, and spiritual determinism (Qadar). Mothers highly valued practices that respected privacy, religious beliefs, and sociocultural traditions during childbirth. While cultural traditions were strongly observed, they did not significantly influence preferences for intrapartum care. In contrast, healthcare accessibility and perceived cultural sensitivity significantly influenced maternal preferences, with mothers showing a greater preference for healthcare services that accommodated their cultural and religious needs. Emergent qualitative themes included religious and spiritual guidance during pregnancy, influence of elders and intergenerational transmission of traditional beliefs, family advice and shared experiences, emotional support and cultural connection, confidence and reassurance in childbirth preparation, traditional practices for physical recovery and childbirth preparation, traditional protective practices during pregnancy, and challenges in balancing traditional beliefs with medical recommendations and evaluating the safety of traditional practices. Cultural and spiritual beliefs remained important aspects of mothers’ childbirth experiences; however, access to healthcare and culturally sensitive services emerged as more influential factors in shaping preferences for intrapartum care. The findings underscore the importance of balancing cultural and religious values with evidence-based maternal healthcare to promote safe, informed, and positive childbirth experiences. Healthcare institutions may strengthen culturally sensitive maternal healthcare programs, improve healthcare accessibility, enhance gender-sensitive practices, and provide continuous cultural competence training for healthcare workers to improve maternal health outcomes and encourage greater utilization of skilled birth services.

cultural sensitivity, facility- based delivery, maternal decision-making, traditional birth process

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