Birth preparedness & complication readiness of pregnant women in Meghalaya, India

Background & objectives Maternal mortality remains a major global health issue, with India, particularly Meghalaya, contributing significantly to the burden. The three delays: decision-making, reaching a healthcare facility, and receiving care are key factors contributing to maternal deaths. Birth preparedness and complication readiness (BPCR) interventions aim to address these delays by preparing women for childbirth and its complications. This study evaluated the BPCR index and the quality of antenatal care (ANC) in Meghalaya, considering the perspectives of both pregnant women and healthcare providers. Methods A mixed-methods design was employed in different blocks of East Khasi Hills District, Meghalaya. A quantitative design was used to assess the BPCR index among 200 pregnant women. Direct observations of a subset of over 10 per cent of the ANC checkups were done to assess their quality. Additionally, in-depth interviews with 14 pregnant women and eight healthcare providers explored factors influencing BPCR and the quality of ANC. Results The BPCR index from this study was 43.4 per cent. Only 5 per cent of pregnant women could identify at least one danger sign of pregnancy. Direct observations revealed that the quality of ANC concerning BPCR was poor, with none of the ANC check-ups incorporating BPCR counselling. In-depth interviews also revealed that none of the healthcare providers were aware of BPCR counselling. Interpretation & conclusion The study revealed a critical lack of awareness about danger signs, contributing to the low birth preparedness and complication readiness. The absence of related counselling during ANC visits highlights a significant gap in maternal care and preparedness in the region.