ABSTRACT

Background: Maternal mortality is an enormous public health burden in developing countries of the world. Birth preparedness and emergency readiness is the process of planning for safe delivery and anticipating the actions needed in case of emergencies. When a woman is adequately prepared for normal childbirth and possible complications, she is more likely to access the skilled and prompt care she needs to protect her overall health and possibly save her life and that of her baby. This descriptive study assessed the birth preparedness and emergency readiness of antenatal clinic attendees in a secondary health facility in Awka, South eastern Nigeria.

Methodology: This is a cross-sectional descriptive study carried out among pregnant women attending antenatal clinic at Amaku

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General Hospital Awka. The data was collected from the pregnant women using semi-structured interviewer administered questionnaire.

Findings: The mean age of the respondents was 27.9 years with a standard deviation of 4.5 years. The proportion of the respondents who were birth prepared was 56% as against 6% who were emergency ready. Up to 59.8% of the respondents of gestational age >=20weeks were birth prepared compared to 12.5% of the respondents of gestational age <20weeks (p=0.027). As much as 67.9% of the respondents of parity one to three were birth prepared compared to 46.9% of the respondents who were primiparous and 25% of the respondents of parity greater than or equal to four (p=0.011). Whereas 85% of the respondents knew at least one danger sign in pregnancy, labour and post-partum, 12% knew four or more while 3% were completely ignorant of the danger signs. As much as 97% of the respondents were on routine drugs, 84% had received tetanus toxoid but only 26% had received

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malaria prophylaxis (intermittent preventive treatment with sulphadoxine and pyrimethamin IPTsp).

Conclusion: Most pregnant women make arrangements in anticipation of normal delivery but the same cannot be said for emergencies.

Key words: Birth prepared, emergency ready, pregnant women,

antenatal.

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CHAPTER ONE

1.0         INTRODUCTION

Pregnancy is the physical condition of a woman carrying unborn offspring inside her body, from fertilization to birth. Child birth is the process of having a baby emerge from the womb. Pregnancy and child birth, under normal

conditions is not a disease but a physiological process.1 It is a blessing and a thing of joy. There is, therefore, no need for any woman to die as a result of

pregnancy or child birth.1 Unfortunately, many women in developing countries of the world face increased risk of morbidity and mortality from pregnancy

and other pregnancy related issues. 1

Birth preparedness and emergency readiness involves active, definite preparation and decisions made by a pregnant woman for birthing including arrangements made for emergencies that may arise at any time in pregnancy,

during delivery or after delivery.2 This planning has the potential to reduce morbidity and mortality during pregnancy, delivery and post-partum by

ensuring faster access to care.2

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Birth preparedness and emergency readiness is also a comprehensive strategy to improve the use of skilled providers at birth, the key intervention to

decrease maternal mortality.3 The concept of birth preparedness and emergency readiness includes the following elements: (a) knowledge of danger signs; (b) plan for where to give birth; (c) plan for a birth attendant; (d) plan for transportation; (e) plan for saving money; and (f) identifying a blood donor in

case of an obstetric emergency. 4

Birth preparedness and emergency readiness is therefore a key strategy in safe motherhood programmes, a global effort that aims to reduce deaths and

illnesses among women especially in developing countries. 5,6 Specifically aimed at reducing maternal mortality, these programmes are being developed

in the wider context of health services for women’s reproductive health. 6

According to the World Health Organisation (WHO), maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not

from accidental or  incidental causes.7  As  stated  by the  2005  WHO  report

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“Make Every Mother And Child Count” the major causes of maternal death are: severe bleeding/haemorrhage (25%), infections (13%), unsafe abortions (13%), eclampsia (12%), obstructed labour (8%), other direct causes (8%), and

indirect  causes (20%) 7. Indirect  causes such as  malaria,  anaemia,  HIV/AIDS

and cardiovascular disease, complicate pregnancy or are aggravated by it. 7

1.1           STATEMENT OF THE PROBLEM

Maternal mortality is a substantial public health burden in developing countries. The World Health Organisation estimates that approximately 536,000 women die from pregnancy and childbirth-related complications each year with

95% of these deaths occurring in sub-Saharan Africa and Asia.8 Africa has the highest burden of maternal mortality in the world and sub-Saharan Africa is largely responsible for the dismal maternal death figure for that region,

contributing approximately 98% of the maternal deaths for the region.