Journal of Pregnancy and Child Health
Open Access

Antenatal care; Maternal Mortality; Maternal Morbidity

Introduction

Situation of maternal mortality in developing countries is very worse as after HIV infection maternal mortality observed as the second major cause of maternal death. In the modern world maternal mortality is the greatest issue faced by not only developing but developed nations also. Maternal mortality is observed as the biggest health issue in third world countries as contrast to developed nations. Pakistan Demographic Health Survey (2006-2007) reported mortality rate is observed as 276 maternal deaths per 100,000 live births. Major causes of maternal deaths included bleeding, repeated abortion and hypertensive disorders. Literature Shows that in South Asian countries maternal and infant mortality rate decreased during the last ten years. Many health related research and past data conclude that antenatal care plays a vital role to reduce the maternal mortality and morbidity [1]. A cross-sectional study found that antenatal care has great association with maternal and infant health. World Health Organization suggested that at least four antenatal visits are compulsory for positive results while in Pakistan more than 70% female reported only one antenatal are visit. According to Pakistan Demographic Health Survey (2007) only 37% female stated that they have four or more antenatal visit during pregnancy. Zozulya explored that illiterate female did not have enough capability to take important decisions related to their own and new born health in case of any emergency. Educated females not only recognized the written instructions of their health provider but also follow them. Maternal health literacy is an important indicator in pregnancy outcomes. Uneducated females could not communicate well with their health professionals and therefore not in a position to understand and follow the health instruction which is the major cause of negative pregnancy results [2, 3].

Materials and Methods

A Cross-sectional survey was conducted in legal residential colonies of Sheikhupura, Punjab. The universe of the present research encompassed of 301 mothers (who were not pregnant at the time of data collection). In order to select the sample for data collection multistage sampling techniques were used. There were 18 legal residential colonies in Sheikhupura and 50% of the total colonies was selected randomly to draw the sample size. With the help of simple random sampling technique one block of each colony was selected by the researcher [4].

Through systematic sampling every 5th house was nominated to collect the data. Mothers who were nor pregnant at the time of data collection were selected by the help of purposive sampling. Along with the descriptive statistics, binary logistic regression applied as in the present study dependent variables was in dichotomous from and independent variable’s were more than two. Binary logistic regression analysis run in order to check the association among maternal literacy, first antenatal care visit, number of antenatal care visits during the whole pregnancy, medical complications faced during pregnancy and pregnancy results [5-7].

Ethical considerations

First of all, permission to get into the communities and interact with door to door was granted from the relevant authorities. Researcher in the current study explained the purpose of study to the respondents before the data collection in order to pursue the voluntary participation of the respondents [8].

Major findings

Demographical Profile of Respondents

Table 1 provides the information about demographic characteristics of the respondents. Most of the respondents reported their age between 18 to 42 years and above than half of the total women were above than 25 years. Result shows that above than 30 percent of the total respondents were reported that they have matric level qualification while above than 25 percent women have their master’s degree. In term of employment status above than 60 percent respondents were unemployed. Majority of the respondents confess that they have above than 40 thousand of monthly income. Above than 70 percent respondents have 1-3 children while rest of the respondents have above than 3 children [9].

Antenatal Care and Complications during Pregnancy

Results indicate that above than 80 percent respondents agreed that they get antenatal care in their last pregnancy while only 16 percent respondents reported that they did not visit any medial institution for antenatal care and checkup. Health care professionals provide available facilities and recommendations to pregnant woman in order to ensure the positive pregnancy results. Results indicate that almost one half of the respondents agreed that they visit hospital in their first trimester. Most of the respondents who did not get medical care in their pregnancy stated that the financial problem was the main reason. Findings indicate that majority of the respondents have 7-9 visits in their last pregnancy. Above than 30 percent females reported that they experienced medical complication while 64 percent respondents did not face any such problems. Total of 7 percent females suffer from gestational diabetes while depression and heart disease was also experienced by the respondents during their last pregnancy. Results indicates that bleeding was observed as the most common medical complication experienced by the pregnant females. Above than half of the total respondents stated that they have unhealthy baby while rest have health baby at the time of birth [11, 12].

Results

In the current study maternal literacy and antenatal care used as independent variable’s in order to predict the pregnancy results. Antenatal care considered as the total number of medical visits during the whole pregnancy, time to start the antenatal care and medical complications such as blood pressure, anemia, sugar and diabetes. Social researchers used binary logistic regression analysis in order to predict the outcomes of any phenomena. Results of the present study indicate that females who have experienced medical complications like diabetes, sugar, blood pressure and anemia have reported negative outcomes which indicates that their newborn babies were not health at the time of their birth. Wald statistics of the current study indicates that only pregnancy related problems correlate with pregnancy outcomes while rest of the independent variable’s did play a significant part to predict the pregnancy outcomes. Research shows that suitable are did not enough when medical problems can be experienced shortly during pregnancy. In such cases it might be possible that respondents who visit the health professionals did not follow the instructions. Major reason of not following the medical instructions included shortage of time and money (Table 4) [13].

In social sciences odds ratio used to explain the association among dependent and independent variable’s. In the present study odds ratio for medical complications shows that for every 1 increase in medical complications leads to 0.004 less chances having a healthy baby. Findings shows that problem faced during pregnancy have direct relation with outcomes which shows that respondents who have experienced the problems reported that they have unhealthy baby at the time of birth. Complication during pregnancy faced by the pregnant women directly affect the mother and newborn and most often such complications result into the newborn or mother death. Antenatal care is important in positive outcomes and to avoid the compilations during pregnancy. In the current study antenatal care and health literacy of pregnant females did not play any part to predict the results of pregnancy (Table 5) [14].

Conclusion

Results of the present research indicates that medical compilations experienced by respondents during their last pregnancy. Blood pressure, depression, bleeding and depressions were observed as the major problems experienced by the females in their last pregnancy. Such problems increase the chances of negative result in the form of either mother or the newborn death. Care during the pregnancy not only effect the female but also newborn directly. First and third trimesters considered as the most crucial stages in pregnancy therefore antenatal care from the first trimester should be encouraged in order to get positive results. Antenatal care visits also play a part in positive results as during such visits health professionals can detect the complications within time and provide the instructions accordingly. Literacy of females did not observe as the stronger predictor of pregnancy outcomes as in the present scenario most of the respondents were not qualified above than matric.

Antenatal care services should have easy access for the overall population of any country in order to maximize the positive results. Availability of health services related to mother and newborn should be easily available in both public and private sectors. Mass media and other electronic channels play a significant part in order to highlight the importance of antenatal care specially in first and third trimester. In order to avoid the negative outcomes both health related knowledge and practices should be highlighted with the help of different channels [15, 16].

Acknowledgement

Not Applicable

Conflicts of Interest

The authors report no conflict of interest.

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