Obstetric danger signs in context: A mixed methods study exploring knowledge and sociocultural factors among pregnant...

Maternal morbidity and mortality persist due to delays in seeking care for obstetric complications. Deficits in comprehending danger signs contribute to preventing early identification. There is limited research on awareness levels among rural Indian women. The present study aimed to assess knowledge of obstetric danger signs among pregnant women in rural Gujarat and explore associated sociodemographic and obstetric history factors. Qualitative methods further elucidated experiences, attitudes, and perceptions underlying maternal health literacy.

A mixed-methods study was conducted among 390 antenatal women selected through multistage sampling from six community health centers in Jamnagar district. A structured questionnaire and in-depth interviews were used for data collection. Quantitative data were analyzed with regression modeling, and qualitative data were thematically analyzed.

Out of 490, the majority correctly identified pregnancy bleeding (73.3%, n = 361), leakage of fluid (71%, n = 347), and swelling (74.3%, n = 364) as danger signs. About 56.5%, n = 277, had good knowledge of danger signs. Knowledge was significantly higher among women aged >25 years (aOR 3.11, 95% CI 2.02-4.7), literate women (aOR 2.14, 95% CI 1.12-4.08), and those counseled during ANC (aOR 2.2, 95% CI 1.2-8.1) and PNC (aOR 4.4, 95% CI 1.8-10.7). Qualitative findings revealed gaps in recall, poor comprehension of symptoms, and sociocultural barriers to care-seeking.

Despite interfacing with health services, awareness of obstetric danger signs was incomplete among rural antenatal women. Tailored education through enhanced counseling and family-centered care can improve maternal health literacy.