Bypassing likelihood increased with primiparity ( odds ratio , OR : 2.5 ; 95 % confidence interval , CI : 1.9-3 .3 ) and perceived poor quality at clinics ( OR : 1.3 ; 95 % CI : 1.0-1 .7 ) and decreased if clinics recently underwent renovations ( OR : 0.39 ; 95 % CI : 0.18-0 .84 ) and/or performed 4 obstetric signal functions ( OR : 0.19 ; 95 % CI : 0.08-0 .41 ) .