Maternal care receptivity and its relation to perinatal and neonatal mortality. A rural study.

ABSTRACT

PIP: The receptivity of 212 pregnant women in rural Uttar Pradesh, India, to prenatal services provided at their homes was assessed during a May 1987 to April 1988 longitudinal study. The women, from four randomly selected villages, were assessed every month until completion of the neonatal period. Receptivity to doorstep prenatal services was calculated by developing a weighted score based on time when prenatal services began, frequency of visits accepted, number of doses of tetanus toxoid immunization accepted, and place of and person attending the delivery. Of the 212 women, 17% had poor, 75.9% had moderate, and 7.1% had high receptivity to the prenatal services. The pregnancies resulted in 5 stillbirths and 12 neonatal deaths before one week, for a perinatal mortality rate of 81.3/1000. 3 of the 8 infants who were in breech presentation died, 2 infants died from congenital defects, 2 from prematurity, 1 from cord prolapse, 1 from jaundice, 1 from fetal distress, and 2 from unknown causes. Another neonate died of meningitis. The perinatal mortality rates were 90.9, 86.9, and 0/1000 births in women with poor, moderate, and high receptivity scores, respectively. The inverse relationship between maternal care receptivity and the mortality rates was statistically significant. The poor receptivity to home-based prenatal care results from ignorance, illiteracy, and poverty and from a deeply rooted confidence in traditional birth attendants. This study also revealed that anemia persisted in 62.2% of these women even after iron and folic acid supplementation. This study highlights the importance of providing health education to pregnant women to increase their receptivity to maternal care services.