Assessment of Birth Preparedness and Complication Readiness among Postnatal Mothers in Tertiary Care Hospital, West Bengal

Abstract

Introduction: Maternal mortality still remains a major public health challenge in India. Delays in seeking, reaching and obtaining to appropriate intranatal care are the crucial factors determining maternal mortality. Birth Preparedness and Complication Readiness (BPACR) is the process of planning for normal birth and anticipating the actions needed in case of an emergency. It is a logical process of addressing delays in delivery. Aim: To assess BPACR status of postnatal mothers using BPACR index and to determine association between socio demographic and other variables and BPACR status among them. Materials and Methods: The cross-sectional, observational study was conducted on 200 post-natal mothers of Indoor Patient Department (IPD), Department of Gynaecology and Obstetrics, in a tertiary care hospital in West Bengal. Socio demographic information and information on antenatal history, decision makers during pregnancy, type and distance of nearest health facility, knowledge of danger signs, identification of the skilled birth attendant, mode of transport, arrangement for money and other variables were collected by interviewing the patients with a predesigned, pretested, semi structured schedule and by reviewing records. BPACR is the process of planning for normal birth and anticipated actions needed during an emergency. To assess BPACR status among postnatal women, BPACR index is measured which consists of a set of indicators. Data were analysed using Statistical Package for the Social Sciences (SPSS) version 20.0. Proportion and chi-square test were used wherever applicable. The p-value of less The p-value of less than 0.05 was taken as statistically significant. Results: The final BPACR index was 61.07. All participants identified skilled birth attendants for delivery. Almost all were aware of Janani Suraksha Yojana (JSY). Among 200 women, about 90% of them had knowledge about transportation services provided by the government. Only 63.5% of the mothers (127/200) availed Antenatal Care (ANC) by skilled provider. About 38.5% (77/200) of study participants identified the mode of transportation, and 38% (76/200) of them saved money for delivery expenses. No participant could identify more than eight danger signs of pregnancy. Overall, 75% (150/200) of participants were well prepared. On bivariate analysis, good preparedness have been found to be significantly associated (p-value <0.05) with age group, type of decision maker during pregnancy and presence of the husband accompanying their wives in any of the ANC visits. Conclusion: Majority of the population were well prepared, but awareness on danger signs was very low. Women empowerment in terms of behavior change communication at family, community and tertiary care level to be carried out through formal and informal approaches are the needs of the hour.