Correlates of Preconception Care among Mothers Prone to Hypertensive Disorders in Nairobi City County

Abstract

Improved uptake of preconception care has been associated with reduced rates of maternal mortality yet the awareness and uptake of preconception care services among pregnant women, and healthcare teams remain low. This study assessed the awareness of preconception care among pregnant mothers with hypertensive disorders, to examine the influence of male partners in seeking of preconception care and to determine the perceived effects of lack of pre-conception care among pregnant mothers with hypertensive disorders. This was a cross-sectional study in which a sample of 325 mothers seeking ante-natal care was selected from Mbagathi District Hospital, Pumwani Maternity Hospital and Langata Health Centre respectively. A stratified proportionate sampling was used to select the 325 mothers from the three health facilities. Structured questionnaires were used in data collection. Descriptive statistics (mean, median, frequency) were used in analyzing characteristics of the sample. Inferential statistics (Chi-square) was used to test for the relationship between the study variables and seeking of pre-conception care. A p-value of 0.05 was considered significant at a 95% confidence level. A majority of respondents n=232 indicated that preconception care consists of advice prior to conception, medical care during pregnancy and receiving ante-natal care. Health workers at 63% (n=174) were the main source of information on pre-conception care. 72.5% of the respondents had discussed a joint pre-conception care with their male partner. About 27.5% of the respondents had not discussed a pre-conception care plan with their male partners with the leading reason being that partners did not see the reason to accompany their wives for pre-conception care. Marital status at p=0.000 (c 2 = 25.365, df=4), education at p=0.048(c 2 = 18.465, df=10), discussing and making joint plans with partner on pre-conception care at p=0.008 (c 2 = 9.782, df=2) significantly influenced decision to attend pre-conception care. 44.67 % (n=130) of respondents indicated that lack of pre-conception care increases the risk of hypertension disorder causing miscarriage. Twenty-eight percent (n=80) of the respondents indicated that lack of pre-conception care exposes a mother to birth complications that develop due pre-eclampsia. This study identified views of mothers on the uptake of pre-conception care. Perceived lack of time and lack of interest among men were the main barriers that hindered male partners from accompanying their female partners for pre-conception care. Factors that promoted uptake of pre-conception care included, being married, discussing a joint plan with a male partner and having a higher level of education. This study highlights the need for health promotion activities to encourage the need of preparing for pregnancy in the general population. In this regard, health care workers should incorporate health messages on preconception care during ante-natal, immunization and post-natal care sessions to increase awareness on the importance of preconception care.