High Risk Pregnancy and its Relation with Maternal Care Receptivity (MCR) — a Rural Study from India

Researchers registered 212 pregnancy women from rural western Uttar Pradesh India to conduct a longitudinal study (May 1987-April 1988) of the impact and extent of use of maternal care services. They measured the extent of these services of assigning scores to 4 factors--gestation period when prenatal care began number of prenatal visits tetanus toxoid immunization and place and person attending delivery--the total of which was the Maternal Care Receptivity score (MCR). The researchers considered 58.5% of the mothers at risk and 41.5% not at risk. The MCRs of those at risk ranged from 1-8. 7.3% of high risk mothers had a high MCR. Since health workers conducted many home visits and they allotted weighted scores based on these visits the moderate MCR was disproportionately higher for both high and low risk mothers. If these visits did not occur they would have noted a much higher percentage of women with poor MCRs. The MCR of 67.7% of high risk mothers was moderate and 25% was poor. Considering low risk mothers 6.8% (6) ranked high 87.5% (77) moderate and 5.7% (5) poor. Thus and inverse relationship existed between MCR and high risk pregnancy (p<.001). None of the low risk women experienced fetal or newborn death. The percentage of fetal and newborn deaths rose as the MCR did (p<.001; 8.1- 100%) except at MCR of 6 (25%). Indeed those with MCRs of 5 and 8 all experienced fetal or newborn death. Perinatal and neonatal mortality rates for high risk pregnancies stood at 137 and 145 respectively. The corresponding rates for high risk pregnancies were 96.7 and 96.7 for women with poor MCR 166 and 119 for those with moderate MCR and 0 and 0 for those with high MCR. In conclusion health care providers must improve MCR and identify high risk pregnancies. An effective health education program can provide the impetus to motivate pregnant mothers.