A Cross Sectional Survey to Assess Knowledge on Birth Preparedness among Primigravida Woman Attending Antenatal Clinic of Selected Municipal Hospital

Background: In spite of important progress towards attaining the Millennium Development Goals (MDGs), maternal and neonatal mortality continue to figure as major public health problems in developing countries [1, 2]. Improvements in maternal health and reductions in maternal mortality have been slower than anticipated and - despite isolated successes - remain far from the MDG5 target of a 75% reduction in the maternal mortality ratio (MMR) from 1990 to 2015 [3]. Maternal mortality is a global burden, about 287,000 women died in 2010 due to pregnancy and childbirth related complications [4]. In India, Maternal Mortality Ratio is 212 per 100,000 live births [5] Morbidities related to pregnancy are related to medical causes which goes uncounted. Most maternal death occurs during delivery due to unpreparedness for childbirth and managing complications, which results in delivery by the mother itself or untrained attendant. These maternal deaths are unjust and avoidable if preventive measures are taken on time like ensuring antenatal care to all mothers, delivery by skilled birth attendant and timely referral to hospital. As in most rural and tribal areas, delivery takes place at home, far from emergency obstetric services or without access to skilled attendant, there is more risk associated with mother and child life [6]. Many birth preparedness programmes widely promoted by governments and international agencies to reduce maternal and neonatal health risks in developing countries; however, their overall impact is uncertain. Thus investigator felt need to assess whether pregnant women have adequate knowledge on antenatal, Intranatal and postnatal preparedness. The aim of the study was to assess pregnant women's knowledge on elements of birth preparedness i.e. antenatal, Intranatal and postnatal preparedness.

Objectives: To determine knowledge of pregnant women on various elements of birth preparedness.

* To identify association of demographic variables with birth preparedness.

Research Methodologies:

* A Quantitative Cross sectional survey was conducted on Primigravida Pregnant women

* Sample technique: Non probability Purposive Sampling

* Sample size: 425

* Setting: Selected municipal corporation hospital

TOOL:

The tool consisted of Semi structured interview and Structured Questionnaire

This had 2 sections-

* Section I-Socio demographic profile of mother

* Section II-Knowledge regarding birth preparedness had 3 major elements Antenatal, Labor, Postnatal preparedness. Total of 32 questions were included among which 10 were antenatal, 10 Intranatal and 12 were postnatal.

Data Collection:

* Phase I: History collection (Section I)

* Phase II: Structured Questionnaire (Section II)

Procedure: All participants fulfilling the criteria were approached, consent was taken and data was collected( section I and II). The average time taken to fill the questionnaire in the antenatal OPD was almost 15-20 minutes.

RESULT:

* Majority of pregnant women (184) were from age group of 18-22, majority of pregnant women 187 (44%) are educated up to SSC and Below, 154 (36.23%) pregnant women are educated up to HSC, 56 (13.17%) pregnant women are educated up to graduate and above and 28 (6.58 %) pregnant women are Illiterate. In gestation wise distribution of samples majority of pregnant women 210 (49.41%) were in second trimester, 117 (27.52%) were in third trimester and 98 (23.05%) were in first trimester and in occupation wise distribution of samples 304 (71.52%) were housewife, 121 (28.47%) were doing service.

* Age, education, trimester, religion and occupation show a significant association with birth preparedness.

* In Birth preparedness there were 10 elements on antenatal preparedness and pregnant women were not having knowledge on 3 elements ie essential laboratory tests and VCT, antenatal exercises andawareness of warning signs during pregnancy.

* In Birth preparedness there were 10 elements on intranatal preparedness and pregnant women were not having knowledge on 9 elements ie Labor and stages of labor, care during stages of Labor, warning signs during labor, Planning of place to deliver the baby, approximate distance of the planned place of delivery, Transportation facility for delivery, articles kept ready for hospital delivery, accompany of chaperone for hospital delivery, financial arrangements for delivery, Blood donors for emergency.

* In Birth preparedness there were 10 elements on postnatal preparedness and pregnant women were not having knowledge on 9 elements ie Diet during post natal period, episiotomy care, awareness about post natal exercises, articles kept ready for baby, awareness about exclusive breast feeding., schedule of breast feeding the baby, awareness about importance of Colostrums, awareness about new born warning signs, vaccination schedule of baby.

Conclusion: As we are aware that birth preparedness includes antenatal, intranatal and postnatal preparedness, pregnant women needs to be prepared in all the three areas. But according to the survey it shows that pregnant women are Knowledgeable about antenatal preparedness but are fairly Knowledgeable about postnatal preparedness and absolutely not knowledgeable about intranatal preparedness. Thus there is a great need to make them knowledgeable about Intranatal preparedness too, it should not be left assumed that once they enter labour process they will be delivered as it is natural process and health care workers will take care of it.