A family-oriented antenatal education program to improve birth preparedness and maternal-infant birth outcomes: A cross sectional evaluation study

Yoko Shimpuku,Kazumi Kubota,Sebalda C. Leshabari,Frida E. Madeni,Shigeko Horiuchi

doi:10.1186/s12978-019-0776-8

Abstract

BackgroundIn Tanzania, the information on Birth Preparedness and Complication Readiness is insufficiently provided to pregnant women and their families. The aim of this study was to evaluate the maternal and infant outcomes of a family-oriented antenatal group education program that promotes Birth Preparedness and Complication Readiness in rural Tanzania.MethodsPregnant women and families were enrolled in a program about nutrition and exercise, danger signs, and birth preparedness. The cross sectional survey was conducted one year later to evaluate if the participants of the program (intervention group) were different from those who did not participate (control group) with respect to birth-preparedness and maternal and infant outcomes.ResultsA total of 194 participants (intervention group, 50; control group, 144) were analyzed. For Birth Preparedness and Complication Readiness, the intervention group participants knew a health facility in case of emergency (OR: 3.11, 95% CI: 1.39–6.97); arranged accompaniment to go to a health facility for birth (OR: 2.56, 95% CI: 1.17–5.60); decided the birthplace with or by the pregnant women (OR: 3.11, 95% CI: 1.44–6.70); and attended antenatal clinic more than four times (OR: 2.39, 95% CI: 1.20–4.78). For birth outcomes, the intervention group had less bleeding or seizure during labour and birth (OR: 0.28, 95%CI: 0.13–0.58); fewer Caesarean sections (OR: 0.16, 95% CI: 0.07–0.36); and less neonatal complications (OR: 0.28, 95% CI: 0.13–0.60).ConclusionsThe four variables were significantly better in the intervention group, i.e., identifying a health facility for emergencies, family accompaniment for facility birth, antenatal visits, and involvement of women in decision-making, which may be key factors for improving birth outcome variables. Having identified these key factors, male involvement and healthy pregnant lives should be emphasized in antenatal education to reduce pregnancy and childbirth complications.Trial registrationNo.2013–273-NA-2013-101.Registered 12 August 2013.

Highlights

In countries where the maternal mortality ratio remains high, antenatal education to increase Birth Preparedness and Complication Readiness (BPCR) is considered one of the top priorities [1]
Having identified four key factors in BPCR, male involvement and healthy pregnant lives should be emphasized in antenatal education to reduce pregnancy and childbirth complications
After eliminating the participants with missing data related to the main outcome variables (n = 20 in intervention group; n = 46 in control group), the valid responses were 194 (n = 50 in intervention group; n = 144 in control group)

Summary

Introduction

In countries where the maternal mortality ratio remains high, antenatal education to increase Birth Preparedness and Complication Readiness (BPCR) is considered one of the top priorities [1]. In a study in the Rufiji region, information, education, and communication about the danger signs of pregnancy are reportedly insufficiently provided; only 61% of the clinics provided information despite the national policy recommending the provision of this information in every visit [6]. In Tanzania, the information on Birth Preparedness and Complication Readiness is insufficiently provided to pregnant women and their families.

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Discussion

Conclusion