The Role and Practice of Nurses in Birth Preparedness and Complication Readiness among Pregnant Women at Tertiary Care Hospitals in Peshawar: Birth Preparedness and Nurses’ Practices in Tertiary Hospitals

Shahida  Parveen; Sehrish  Naz; Dildar  Muhammad; Shahnaz; Samina  Haider

Authors

Shahida Parveen Hamdan Institute of Nursing Sciences, Sawabi, Pakistan
Sehrish Naz Khyber Medical University, Peshawar, Pakistan https://orcid.org/0000-0003-4282-3462
Dildar Muhammad Khyber Medical University, Peshawar, Pakistan
Shahnaz National College of Nursing, Peshawar, Pakistan
Samina Haider Govt Nursing College, Ayub Medical Complex, Abbottabad, Pakistan

Keywords:

Birth Preparedness, Complication Readiness, Nurses Role, Practice, Pregnant Women

Abstract

Background: Birth preparedness and complication readiness (BPCR) encourages pregnant women to use professional health services and receive timely information to prevent complications that lead to maternal mortality. Despite the critical role of nurses in maternal healthcare, limited research has explored their specific contributions to BPCR implementation in developing countries like Pakistan.

Methods: A cross-sectional analytical study was conducted at two tertiary care hospitals in Peshawar using universal sampling technique. A sample size of 76 nurses working in gynecology departments was selected. Data were collected using pre-tested and pre-validated questionnaires with content validity of 0.89 and Cronbach's alpha of 0.9. Structured observation checklists were used to assess actual practices. Statistical analysis was performed using SPSS version 22.

Results: The study reveals that majority of nurses strongly agree on their responsibilities in educating pregnant women about prenatal care (61%) and health education (59%). Direct supportive care during labor was acknowledged by 63% of participants. However, variability exists in practices, particularly in emergency planning where only 29% provided comprehensive emergency preparedness plans. Practice observations showed 95% collaboration with other professionals, 91% hygiene education, and 84% dietary counseling. A significant correlation was found between nurses' roles and BPCR practices (p = 0.049 < 0.05).

Conclusion: This study emphasizes the critical role of nurses in promoting Birth Preparedness and Complication Readiness among pregnant women. While nurses demonstrate strong role recognition, implementation gaps exist particularly in emergency preparedness. The study highlights the importance of structured training programs to enhance BPCR practices and improve maternal and neonatal outcomes.

DOI: https://doi.org/10.59564/amrj/03.03/003

Author Biographies

Shahida Parveen, Hamdan Institute of Nursing Sciences, Sawabi, Pakistan

Principal/Assistant Professor, Department of Nursing

Sehrish Naz, Khyber Medical University, Peshawar, Pakistan

Assitant Professor, Department of Nursing

Dildar Muhammad, Khyber Medical University, Peshawar, Pakistan

Professor, Department of Nursing

Shahnaz, National College of Nursing, Peshawar, Pakistan

Principal, Nursing

Samina Haider, Govt Nursing College, Ayub Medical Complex, Abbottabad, Pakistan

Nursing Instructor, Department of Nursing

References

Girum T, Wasie A. Correlates of maternal mortality in developing countries: an ecological study in 82 countries. Matern Health Neonatol Perinatol. 2017 Nov 7;3:19.

DOI: https://doi.org/10.1186/s40748-017-0059-8

World Health Organization. WHO recommendations on health promotion interventions for maternal and newborn health.2015. Available from: http://www.ncbi.nlm.nih.gov/books/NBK304983/.

Maternal mortality. Available from: https://www.who.int/news-room/fact-sheets/detail/maternal-mortality.

Pakistan. In: The World Factbook [Internet]. Central Intelligence Agency; 2022 Available from: https://www.cia.gov/the-world-factbook/countries/pakistan/#people-and-society.

Omer S. The Social and Cultural Factors of Maternal Mortality in the Context of Three Delays: The perspective of Lady Health Workers of South Punjab, Pakistan. 20(1):8.

Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014 Jun; 2(6):e323-33.

DOI: https://doi.org/10.1016/S2214-109X(14)70227-X

Aziz A, Saleem S, Nolen TL, Pradhan NA, McClure EM, Jessani S, et al. Why are the Pakistani maternal, fetal and newborn outcomes so poor compared to other low and middle-income countries? Reprod Health. 2020 Dec; 17(S3):190.

DOI: https://doi.org/10.1186/s12978-020-01023-5

Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, Gülmezoglu AM, Temmerman M, Alkema L. Global causes of maternal death: a WHO systematic analysis. The Lancet global health. 2014 Jun 1;2(6):e323-33.

DOI: https://doi.org/10.1016/S2214-109X(14)70227-X

August F, Pembe AB, Kayombo E, Mbekenga C, Axemo P, Darj E. Birth preparedness and complication readiness -- a qualitative study among community members in rural Tanzania. Glob Health Action. 2015 Dec 8(1):26922.

DOI: https://doi.org/10.3402/gha.v8.26922

Ghani U, Crowther S, Kamal Y, Wahab M. The significance of interfamilial relationships on birth preparedness and complication readiness in Pakistan. Women Birth 2019 Feb;32(1):e49--56.

DOI: https://doi.org/10.1016/j.wombi.2017.12.010

Barco RCD. JHPIEGO Brown's Wharf 1615 Thames Street Baltimore, Maryland 21231-3492, USA.FAM CARE. : 338. In.

Kibicho S. Maternal Health Guidelines Approved By the WHO Guidelines Review Committee. Available from: https://www.academia.edu/36400615/Maternal Health Guidelines Approved By The Who Guidelines Review Committee.

Mgbekem MA, Nsemo AD, Daufa CF, Ojong IN, Nwakwue N, Andrew-Bassey P. Nurses' Role in Birth Preparedness and Complication Readiness among Pregnant Women in University of Calabar Teaching Hospital, Calabar. Health (N Y). 2020 12 (02):71-85.

DOI: https://doi.org/10.4236/health.2020.122006

Okojie Hilda Obehi1 OAI. Knowledge of Birth Preparedness and Complication Readiness and Associated Factors among Health Care Providers in Benin City, Edo State Pregnancy Child Health. 20163(5):8.

Akshaya KM, Shivalli S. Birth preparedness and complication readiness among the women beneficiaries of selected rural primary health centers of Dakshina Kannada district, Karnataka, India. Puthussery S, editor. PLOS ONE. 2017 Aug 24; 12(8):e0183739.

DOI: https://doi.org/10.1371/journal.pone.0183739

Marchione J. Framework for Assessing the Pattern of the Whole. In: Margaret Newman: Health as Expanding Consciousness [Internet]. Thousand Oaks: SAGE Publications, Inc. p. 25--32.

Qazi U, Latif A, Irshad G, Malik FR, Anwar S. Assessment of birth preparedness and complication readiness among pregnant women attending the Obs/Gynae wards in two teaching hospitals in Peshawar, Khyber Pakhtunkhwa, Pakistan. IntJ Gyneco/Obstet.2020Sep;150(3):3248.

DOI: https://doi.org/10.1002/ijgo.13246

Akinwaare MO, Oyebode AO, Brown VB, Ogunniran AA, Adeleye KK. Content of Antenatal Education and Modalities of Delivery among Nurses in Oyo State, Nigeria. Eur J Med Health Sci. 2021 Apr 27;3(2):185--91.

DOI: https://doi.org/10.24018/ejmed.2021.3.2.751

Swindells C, Willmott S. Degree vs diploma education: increased value to practice. Br J Nurs. 2003 Oct 1; 12(18):1096--104.

DOI: https://doi.org/10.12968/bjon.2003.12.18.11708

Bintabara D, Mohamed MA, Mghamba J, Wasswa P, Mpembeni RNM. Birth preparedness and complication readiness among recently delivered women in chamwino district, central Tanzania: a cross sectional study. Reprod Health. 2015 Dec; 12(1):44.

DOI: https://doi.org/10.1186/s12978-015-0033-x

Gama SGN da, Viellas EF, Torres JA, Bastos MH, Brüggemann OM, Theme Filha MM, et al. Labor and birth care by nurse with midwifery skills in Brazil. Reprod Health. 2016 Oct; 13(S3):123.

DOI: https://doi.org/10.1186/s12978-016-0236-7

Al-Kalaldeh M, Amro N, Qtait M, Alwawi A. Barriers to effective nurse-patient communication in the emergency department. Emerg Nurse. 2020 May 5;28(3):29--35.

DOI: https://doi.org/10.7748/en.2020.e2019