Birth preparedness and complication readiness among pregnant mothers with previous uterine scar attending Kawempe National Referral Hospital-Uganda

Abstract

Introduction: Birth preparedness and complication readiness (BPCR) is aimed at reducing maternal and neonatal mortality by mitigating the three delays of obtaining maternal and Neonatal care. Previous uterine scar increases the risk of uterine rupture and associated mortality and morbidity in pregnant mothers in subsequent pregnancies, this study sought to evaluate the level of BPCR and associated factors among mothers with prior uterine scars. Methods: This was a cross sectional study conducted at the antenatal clinic of Kawempe National Referral Hospital among pregnant mothers with previous uterine scar at >37 weeks of Amenorrhoea. Eligible mothers were consecutively selected and consented at the antenatal clinic. A pre-tested interviewer administered questionnaire was used to collect socio-demographic data, clinical data and information regarding BPCR. Data analysis was done using SPSS version 23. A participant was considered prepared if she had done at least 7 out of 10 BPCR parameters. Logistic regression analysis including bivariate and multivariate analysis was done to measure association between dependent and independent variables. At multivariate level, statistical significant was established at a P-value <0.05. Results: We enrolled a total of 390 mothers between 14th /Nov/2023 .and 06th /Feb/2024. The average age of respondents was 30 years , 96.4% were married, 52.1% were employed, 85.9% had at least secondary level of education, 64.1% of the spouses were self employed , 95.4% of the spouses had atleast secondary education. .The majority of respondents (81.0%) demonstrated preparedness for childbirth and its potential complications. The best practiced was identification of place of delivery(100%) and the least practiced was identification of compatible blood donors at 18.5%. Bivariate analysis revealed maternal level of education, occupation, marital status, spouse’s level of education, monthly income, household decision maker, gestational age at 1st ANC ,and thinking that danger sign threaten life of a woman as factors associated with BPCR..Multivariate analysis revealed that BPCR was significantly associated with the spouse's level of education (aOR=3.52, P-Value 0.027), spouse's monthly income (aOR=2.411, P-Value 0.028), perception of danger signs threatening women's lives (aOR=28.18, P-Value 0.008), and early initiation of the first antenatal care (ANC) visit (aOR=1.87, P-Value 0.045). Conclusion: Pregnant mothers with a previous uterine scar were found to be well prepared for birth and its complications despite the challenges in identifying a compatible blood donor. This was influenced by husband’s education and income status, early initiation of ANC and attitudes towards danger signs of pregnancy. To promote BPCR, there is a need to foster collaborative efforts between pregnant mothers and their spouses, to promote early initiation of ANC and to support mothers in identifying a compatible blood donors and skilled health care providers.