Determinants of self medication practices among pregnant women in Ibadan, Nigeria

Objective To assess the frequency and evaluate the factors underlining self-medication with orthodox and herbal medicines among pregnant women in Ibadan, Nigeria. Setting Antenatal clinics at the major antenatal care facility in Ibadan, south-western Nigeria. Methods A prospective cross-sectional study with a pre-tested 15-item structured questionnaire over a 12 week period among 1,650 pregnant women who attended antenatal clinics at a major antenatal care facility in Ibadan, south-western Nigeria. Data analysis was done with Chi-square, multivariate logistic regression and summary statistics. Main outcome measure Frequency and major factors associated with self-medication in pregnancy. Results The response and completion rate was 96.6% (1,594) [mean age ± SD 27 ± 5.3 years]. The majority of the respondents were literate (92.6%), self-employed (61.5%) and in the third trimester (49.5%). A significant majority (63.8%) used self-medication (orthodox and herbal medicines) as their first response to perceived ill-health (P < 0.001). Self-medication in pregnancy was strongly associated with self-employment (OR: 3.8 (2.6–4.7), unemployment (OR: 2.6 (1.4–4.2) and third trimester of pregnancy (OR: 4.2 (3.1–5.6). The major over-the-counter medicines and potentially harmful prescription medicines kept at home for self-medication were Paracetamol, vitamins and haematinics; and piroxicam, dipyrone, chloramphenicol and Diazepam respectively. About one-third of the respondents who self-medicated (1,017) used local herbs (31.2%). The most frequent source of the medicines purchased during self-medication was patent medicine stores (55%). Mothers-in-law and relatives (41.3%) were the most frequently cited sources of advice during self-medication. Miscarriage/bleeding (44.3%) was the most frequently cited potential adverse effect that could occur with the use of certain medicines during pregnancy. Only 32% of respondents could identify medicines that are potentially harmful in pregnancy. Conclusion Poorly guided self-medication with prescription, over-the-counter and herbal medicines is pervasive and significantly associated with gestational age and occupational pattern among pregnant women in Ibadan, south-western. A majority lacked the knowledge of potential adverse outcomes associated with the use of certain medicines, and the potentially harmful medicines to avoid during pregnancy.