Birth Preparedness and Obstetric Danger Signs: Perception and Predictors among Expectant Mothers in Southwest Nigeria

Planning for safe delivery and anticipating actions needed during obstetric emergencies are vital strategies towards reduction in maternal mortality and morbidity. Study explored perception about danger signs of pregnancy among expectant mothers, assessed level of knowledge about danger signs of pregnancy, examined birth preparedness and related factors among expectant mothers in Ogbomosho, southwest Nigeria. Study employed sequential explanatory mixed method design. Quantitative data was collected using questionnaire adapted from John Hopkins Program for International Education in Gynaecology and Obstetrics, JHPIEGO (2004) from 483 expectant mothers, selected through multistage sampling technique. Binary logistic regression examined relationship between dependent and independent variables, p < 0.05 was significant. Focus Group discussion was conducted among 32 participants selected purposively, qualitative responses were analyzed thematically. Quantitative findings revealed that 34.8% of the mothers had good knowledge about danger signs of pregnancy, 65.2% had poor knowledge,36.9% had adequate preparation towards childbirth while 63.1% had inadequate preparations. Binary logistic regression analysis shows that good knowledge about danger signs of pregnancy (p=0.03, OR=0.54. CI=0.31-0.94) was the main predictor of birth preparedness among expectant mothers. Main themes from qualitative responses include knowledge about obstetric danger signs; recognition of obstetric danger signs; perceived severity of obstetric danger signs and perceived susceptibility to obstetric danger signs. Good knowledge about obstetric danger signs was the main predictor of birth preparedness; effective maternal health services aiming at favourable pregnancy outcomes should focus on educating women on early identification of obstetric danger signs and prompt decision making capabilities.