Knowledge and practices of birth preparedness and complication readiness among pregnant women in Eastern Province, Zambia: A qualitative study

Birth preparedness and complication readiness are key strategies for reducing maternal and neonatal mortality. This study aimed to explore the knowledge and practices of birth preparedness and complication readiness among pregnant women attending antenatal care in selected health facilities, using qualitative insights to identify barriers, facilitators and cultural factors. A phenomenological qualitative approach was used to explore pregnant women's knowledge and experiences of birth preparedness and complication readiness. Participants were recruited through convenience sampling, and a total of seven focus group discussions (FGDs) were conducted across seven health facilities, involving 53 participants. Data collection took place in July 2023, and the transcripts were systematically analyzed using NVivo software to identify key themes and patterns emerging from participants' narratives. Four identified themes were knowledge of birth preparedness and complication readiness; knowledge of danger signs of pregnancy; practices of birth preparedness and major delays to seek care. Participants listed common labour and delivery requirements. However, for complication readiness, most of them knew the types of complications but had little knowledge about preparation for such complications. Challenges such as lack of money to buy birth requirements and inadequate partner support led to poor preparations for pregnancy and childbirth. The use of traditional medication to hasten labour negatively influenced early care seeking. Distance to health facilities and lack of transport delayed access to healthcare. We found that pregnant women understood labour requirements but lacked knowledge on complication readiness. Financial constraints, insufficient partner support, reliance on traditional medicine, and long distances to health facilities hindered preparedness. This highlights the need for education, partner support and accessible healthcare.