To Asses the Knowledge of Women in Regards to Antenatal Care

To Asses the Knowledge of Women in Regards to Antenatal Care

1. Farhana Anjum 2. Nasreen Noor 3. Saeeda Bano

1. Asstt. Prof. Gynae and Obst. Isra University Hospital Hyderabad 2. Senior Registrar, Gynae and Obs., LUH, Hyderabad 3. PG student, Gynae and Obs., LUH, Hyderabad


Objective:To evaluate the awareness of women associated to antenatal care at Asian Institute of Medical Sciences Hyderabad.

Study Design: Observational study

Place and Duration of Study: This study was conducted at Gynae/Obs Outpatient Department of Asian Institute of Medical Sciences Hyderabad and LUMHS Hyderabad from 1st January 2014 to June 30th, 2014.

Materials and Methods: Total 150 women were selected in the study. All the awareness regarding antenatal care of the women was documented on Performa.

Results: Total 150 women were selected in the study, mostly cases 53.3% were more than 31 years of the age. Majority of the women 64.4% were uneducated. 69% chose doctors as primary provider for antenatal care, 11% nurses, 19% trained birth attendants. 52% women wished to receive care at home while 47% said at hospital. 70% responded yes to understanding what antenatal care was while 30% had no awareness.  89% of women responded yes it is necessary to have antenatal care while 11% responded that no it is not necessary. 

Conclusion: Awareness regarding antenatal is very rare in the women. Women seek antenatal care only when they are symptomatic and not as a preventive or screening measure. The time of pregnancy is a necessary time period during which the promotion of healthy behaviours is imperative. Participation of the family members and the community can perform a very important role for healthy women during pregnancy.

Key Words: Pregnancy, awareness, antenatal care.

Citation of article: Anjum F, Noor N, Bano S.To Asses the Knowledge of Women in Regards to Antenatal Care.Med Forum 2015;26(2): 23-26.


WHO characterizes antenatal care as a dichotomous variable, having had one or more visits to a prepared individual amid the pregnancy.1 It incorporates routine checkups gave to all pregnant ladies at essential consideration level from screening to escalated life backing along with pregnancy and up to the delivery.2

Correspondence: Dr. Farhana Anjum,

Assistant professor of Gynae and Obst.,

Isra University Hospital Hyderabad

Cell No.: 0333-2700192, 0300-3013807   

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.







Routine antenatal consideration incorporates medicinal intercessions and guidance that a lady gets amid pregnancy and is a key indicator that pregnant ladies get an expansive scope of wellbeing advancement and preventive wellbeing services,3 including learning about solid works on amid pregnancy, dietary help, aversion and treatment of sickliness, conclusion and treatment of different ailments and tetanus toxoid immunization..4,5 Furthermore, routine antenatal care can be given at both the family unit and essential social insurance level and serves to guarantee a connection to larger amounts of consideration when required.6,7 The World Health Organization suggests that a lady without intricacies ought to have no less than four antenatal care visits beginning from the first trimester to get sufficient pre-birth consideration to minimize and the complications of the pregnancy.8,9

Pakistan is one of the 11 nations that represented 65% of worldwide maternal mortality in 2008. These nations, which likewise included India and Bangladesh, have a significant experience in maternal deaths worldwide.10 In Pakistan, the Maternal Mortality Rate (MMR) is elevated in country zones and in less developed provinces.11 The circumstances in Balochistan are particularly serious. In Balochistan, the MMR remains at 750 maternal deaths every 100,000 live births, as contrasted with 227, 314, and 275 in alternate regions of Punjab, Sindh and Khayber Pakhtoon Khwa, respectively.12  Utilization of routine antenatal consideration at government wellbeing offices in Pakistan for the most part is low. Antenatal care Administration in country zones is lower at around 10%. The District Health Information System in Balochistan reported just 15% of pregnant ladies enlisted for antenatal care in 2010-11.13

The Government of Pakistan has been giving maternal wellbeing administrations amid the most recent two decades through essential, auxiliary, and tertiary wellbeing offices, increased by the Lady Health Workers (LHW) Program.13 Around 100,000 LHWs are the foundation of the essential social insurance framework.  Sufficient antenatal care having great association with the negative birth outcomes like as low birth weight, premature birth. Accessing AC in a appropriate manner facilitate women to get knowledge starting in their pregnancies along with complete screening tests.14   Absence of antenatal consideration, particularly in rustic ranges of Pakistan, is a main reason for maternal and foetal mortality in pregnant women. The quantity of ladies having antenatal consideration is low in many regions and needs to be enhanced for the wellbeing of the people.2 Therefore the purpose behind the study to focus the consciousness of ladies with respect to antenatal consideration convenience partner to the ladies amid pregnancy.


This prospective observational study was completed at Gynae/Obs OPD branch of Asian Institute of Medical Sciences, and Liaquat college clinic Hyderabad from January first, 2014 to June 30th, 2014. 150 ladies were chosen in the study. All ladies of reproductive age with past history of equality were incorporated in this study. All unmarried women and nulliparous women were barred from this study. An aggregate of 150 ladies was randomly chosen over duration of six months for this study. The information was gathered through a semi-organized poll made out of five questions. All the knowledge with respect to antenatal consideration was recorded. All the information was investigated by utilizing the SPSS version 16.0.


Total 150 women were included in the study, majority of the cases 53.3% were above 31 years of the age, while 46.6% women were under 30 years of the age. 56.6% women having low parity (<4 children), while 43.3% women were found with high parity (>4 children). Majority of the women 64.4% were uneducated, while 36.6% were educated.Table 1.

Table No. 1. Basic characteristics of the women.



Frequency/( %)


<30 years

>31 Years


<4 children (low)

>4 children (high)

Educational status













From a total of 150 women, 69% (n=104) chose doctor as primary provider for antenatal care, 11% (n=16) nurse, 19% (n=29) trained birth attendant, and .006% (n=1) did not know.Figure 1.

Figure No. 1. Distribution of the antenatal care provider. N=150

                                  Place of Antenatal Care

Figure No. 2: Distribution of the places for antenatal care provider. N=150


Table No.2:Distribution of women regarding knowledge of antenatal care. N=150


Frequency/( %)

Knowledge/understanding of antenatal care



Necessaryof antenatal care



Knowledge regarding component  of antenatal care





don’t know 
















Froma total of 150 women, 52% (n=79) of women wished to receive care at home while 47% (n=70) said at hospital. About .006% (n=1) did not know.Figure 2.

From a total of 150 women, 70% (n=105) responded yes to understanding what antenatal care was while 30% (n=45) did not understand. 89% (n=134) of women responded that yes it is necessary to have antenatal care while 11% (n=16) responded no it is not necessary.  Investigations 55% (n=82) and diet 54% (n=81) were major concerns during antenatal care.Table 2.


In Pakistan, wellbeing administrations are poor by and large; however they are especially inadequate for maternal wellbeing prompting antagonistic results for both ladies and infants. Antenatal care is named as one of the four pillars of the safe motherhood initiative: although its relative contribution to maternal health care has been under debate, its importance cannot be denied. In the present series a total of 150 women from a reproductive age group were selected randomly for study and majority of the cases 53.3% were above 31 years of the age, while 46.6% women were under 30 years of the age. 56.6% women having low parity (<4 children), while 43.3% women were found with high parity (>4 children). Nisar N, et al 15 reported mean age 29+3.95 years.

Educational status is important effectible factor on early AC. Long et al.16 Mentioned that ladies of western China those having less educational status were less likely to get AC. Nisar N, et al 15 mentioned 40% women were illiterate, 47% educated up to primary education and 9% secondary level. Advanced educational status tend to positively concern Health-seeking behaviours, and the educational status also can play important role in the birth control.17 There are various clarifications for why instruction is a key determinant of demand. Education is likely to enhance female autonomy: women thereby develop greater confidence and capabilities to make decisions regarding their own health, as well as their children's health. It is likely that more instructed ladies look for higher quality administrations and have more noteworthy capacity to utilize medicinal services and inputs to deliver better wellbeing. This study also found majority of the women 64.4% uneducated.

In this study 52% of women wished to receive care at home while 47% said at hospital and .006% did not know.The reasons were primarily due to low income sources, they believed home provided a more aseptic environment as compared to hospitals, there was no tradition of antenatal care due to lack of doctors in villages, spouses did not agree with the concept, a family member was a trained birth attendant, antenatal care facilities should only be taken when symptoms or illnesses arise during pregnancy. Similarly in a study of  Karachi, mentioned , among the women who did not receive antenatal care, 28% reported that they did not know it was required, 10% were not advised by anyone, 8% said that they did not have permission from home, 10% found the facility to be far away, 7% reported that transport was not available and 37% did not have any reason.18

Ghafar A, et al19 reported that majority of women 57.7% had a negative attitude towards the antenatal care of pregnancy, and 42.3% had a positive attitude. While in this study 70% responded yes to understanding what antenatal care was 30% (n=45) did not understand. On other hand 89% of women responded that yes it is necessary to have antenatal care while 11% responded no it is not necessary. From all of the women 55% had knowledge that, Investigations are essential during pregnancy and 54% women suggested that diet is a major concern during antenatal care.


The idea of antenatal consideration is not clear till now in the minds of numerous ladies. Ladies are confronting numerous troubles to go to the clinic in view of transportation issues, or that authorization by the spouse is not given, an individual is not accessible to go with the lady to a health centre, and that the expense of antenatal consideration is in large quantity of their base wages.  Family and community should participate amid pregnancy. Their backing can give support and inevitably enhance the wellbeing of mother and the unborn tyke. Antenatal consideration can go about as a vehicle for various intercession projects, for example, administration of iron deficiency, jungle fever, sick health, immunizations, and sexually transmitted illness. Training is exceptionally vital, it is likely that more instructed ladies look for higher quality administrations and have more notable capacity to utilize medicinal services inputs to create better health.


1.       World Health Organization. Essential elements of obstetric care at first referral level. Geneva: WHO; 1991.

2.       Sadiq N. Waheed Q. Hussain M. Rana AT. Yousaf Z. Chaudry Z. et al. Factors affecting the utilization of antenatal care among women of reproductive age in Nurpur Shahan. J Pak Med Assoc 2011;61(6):616-18.

3.       Carroli G. Rooney C. Villar J. How effectiveness is antenatal care in preventing maternal mortality and serious morbidity? An overview of the evidence Paediatric and Perinatal. Epidemiol 2001;15(1):

4.       Wehby GLMurray JCCastilla EELopez-Camelo JSOhsfeldt RL. Prenatal care effectiveness and utilization in Brazil. Health Pol and Plan 2009;24(3);175-188.

5.       Matthews Z. Mahendra SH. Kilaru A.  Ganapathy S. Antenatal care, care-seeking and morbidityin rural Karnataka, India: results of a prospective study. Asia Pacific Popu J 2001;16(2):11-26.

6.       Titaley CR. Dible MJ.  Roberts CL. Factors associated with underutilization of antenatal care services in Indonesia: results of Indonesia Demographic and Health Survey 2002/2003 and 2007. BMC Public Health 2010;10(1):485.

7.       Heaman MI, Newburn-Cook CV, Green CG, Elliott LJ, Helewa ME. Inadequate prenatal care and its association with adverse pregnancy outcomes: A comparison of indices. BMC Preg and Child 2008;8(1):15.

8.       Beeckman K. Louckx F.  Putman K. Predisposing, Enabling and Pregnancy- Related Determinants of Late Initiation of Prenatal Care. Matern Child Health J 2011;15(7):1067-75.

9.       Beeckman K. Louckx F.  Putman K.  Determinants of the number of antenatal visits in a metropolitan region. BMC Pub Health 2010;10(1):527.

10.    WHO. Trends in maternal mortality, 1990 to 2008, 2010.

11.    Midhet F,  Becker S. Impact of community-based interventions on maternal and neonatal health indicators: Results from a community randomized trial in rural Balochistan, Pakistan. Reprod Health 2010;7(1):30.

12.    Khan YP. Bhutta SZ. Munim S. Bhutta ZA. Maternal Health and Survival in Pakistan: Issues and Options, J Obstet Gynaecol Can 2009;19(31); 920-929.

13.    EMRO: Health Systems Profile Pakistan. Eastern Mediterranean Region. World Health Organization 2007;80-109.

14.    Rowe RE, Magee H, Quigley MA, Heron P, Askham J, Brocklehurst P. Social and ethnic differences in attendance for antenatal care in England. Pub Health 2008;122(12):1363–1372.

15.    Nisar N, Amjad R. Pattern  of  antenatal  care  provided at public  sector  hospital  Hyderabad  Sindh. J Ayub Med Coll Abbottabad 2007;19(4): 11-3.

16.    Long Q, Zhang T, Xu L, Tang S,  Hemminki E.  Utilisation of maternal health care in western rural China under a new rural health insurance system (New Co-operative Medical System). Trop Med Int Health 2010;15(10):1210–1217.

17.    McNamee P, Ternent L, Hussein J. Barriers in accessing maternal healthcare: evidence from low-and middle-income countries. Expert Rev Pharm Out Res 2009;9(1):41–48.

18.    Nisar N, White F. Factors affecting utilization of Antenatal Care among reproductive age group women (15-49) years in an urban squatter settlement of Karachi. JPMA 2003;53:47-53

19.    Ghaffar A. Pongpanich S.  Chapman RS.  Alessio Panza, Sheh Mureed S. Ghaffar N. Provision and Utilization of Routine Antenatal Care in Rural Balochistan Province, Pakistan: a Survey of Knowledge, Attitudes, and Practices of Pregnant Women. J Appl Med Sci 2012;1(1):93-116.