Perceptions of essential obstetric care by rural pregnant women and safe motherhood approaches: An interventional study

Objectives To assess the level of awareness about Antenatal and Postnatal care in rural women, to understand health seeking patterns of pregnant women, to relate socio-economic factors to the health seeking patterns, to provide awareness and interventions. Methodology A prospective interventional study was conducted over a period of 6 months among the patients of a government district hospital of Kerala; in three phases: pre interventional, interventional, and post interventional phase. Results Before providing intervention, 89.8% of mothers were aware that vaginal bleeding is one of the danger signs of pregnancy, which increased to 99.8% post intervention. Similarly, they also became aware that convulsions (99%), severe abdominal pain (96.8%) and persistent headache with visual disturbances(98.4%) were the danger signs of pregnancy. The knowledge about pregnancy induced hypertension (99.2%), gestational diabetes (99.6%), gestational anemia(98.8%) and gestational epilepsy(96.2%) had increased post intervention. Initially, 55.2% of women were not aware of any of the diseases. After intervention it decreased to 0.2%. The knowledge on Bacille Calmette Guerin(BCG), Hepatitis B, Polio, Diphtheria Tetanus toxoids Pertussis(DTP) had a notable increase (98.4%,97.6%, 98.2%, 91.6% respectively) after intervention. Also, 35.2% of the women did not know why any of these vaccines were given. After the intervention the value declined to 0.8%. Conclusion This study recognizes the need to focus on the factors associated with utilization of the available free safe motherhood services across all public health facilities. Community engagement and social awareness could play a very crucial role to help promote maternal health.