INTRODUCTION:

Maternal death is an avoidable tragedy; thereby we can prevent it

Theme of White Ribbon Alliance-2000

• Every year, approximately 600 000 women die of pregnancy-related causes (90% Asia and sub-Saharan Africa, 25% India)

• 3 million suffer childbirth related injury, 8 million infants die, 6 million in first month of life. More than 80% of maternal deaths worldwide are due to five direct causes:

• haemorrhage

• sepsis

• unsafe abortion

• obstructed labour

• hypertensive disease of pregnancyThe maternal deaths due to above causes can be preventable by the effective antenatal care.

NEED FOR THE STUDY:

Self-help is always the best help. Giving health in individual’s hands will make them more responsible towards their health. As per the Health Policy Perspective
(WHO 2000, APHA 2001, SOGC 2008, Cochrane 2009) .the Evidence based care, which includes preventive health education, can bring out the following Outcomes;

– Improved maternal and fetal outcomes

– appropriate use of technology

– allocation of resources

– Cost effectiveness.

– Safety of birth

– Satisfaction of care provider (Hundley et al 1995) and client

North American research has demonstrated safety of home birth and the desire and need for midwifery in rural environments (Kornelsen et al. 2005a; 2005b, 2008). So, if midwife gives re-enforcement of antenatal care we can get safe motherhood and healthy child. Because, 30% of Gynecological care provided by midwives (Malott, JOGC, 2009) and 30-40% primary care for women and babies

This particular study focuses on supportive education, self-care, partnership, individualized care to the primigravidae mothers and the effect of it on outcome of baby.

STATEMENT OF PROBLEM:

A study to assess the effect of re-enforcement of antenatal care on outcome of baby among primigravidae at selected hospital at Chennai.

OBJECTIVES:

1. To determine the effect of re-enforcement of antenatal care on outcome of baby.

2. To associate the outcome of baby with the selected background variables

HYPOTHESIS:

• There is a significant improvement in outcome of baby among primigravidae who had re-enforcement of antenatal care than who had not.

METHODOLOGY:

• The design -quasi –experimental design with post-test only. It includes manipulation, control and no randomization.

• All primigravidae attending antenatal OPD were population of this study.

• 80 samples, with inclusion criteria were selected through convenient sampling technique.

TOOLS:

• Semi-structured questionnaire for - Background variables

• Checklist for - outcome of baby. It consists of 10 variables

Preterm baby, Weight of the baby,

IUGR, APGAR scoring,

Respiratory distress Neonatal jaundice, IUD,

Neonatal death Neonatal seizures

DATA COLLECTION PROCEDURE AND TECHNIQUES:

· Interview done using semi -structured questionnaire and information collected about the background variables.

· Review of obstetrical records of primigravidae done for the maternal and fetal outcome

DATA ANALYSIS:

Collected data were organized and analyzed using the Descriptive statistics (Percentage. Mean, SD) and inferential statistics (CHI-SQUARE, ANOVA)

Distribution of demographic variables in study and control group (N=80)

The demographic variables showed no significant difference between the 2 groups. majority of them belongs to the age group of 21-25 years (51%), 48% of them .had secondary education,75% of mothers were housewives. With moderate work activity,

52% of them were with monthly income of Rs.3000-4000, 74% were living in Urban area, and 68% were belongs to nuclear family.

FINDINGS:

• No significant difference in background variables (age, education, occupation, socioeconomic status, religion and habitant) between the study and control group.

• The outcome of baby in study group showed significant improvement than control group in all the aspects.

• The overall effect of re-enforcement of antenatal care on outcome of baby was significant at the level of p<0.001 with a “t” value of 14.32.

• There was no significant association between the background variables and the outcome of baby in both groups. so, the hypothesis formulated was accepted.

Comparison of Mean and SD on outcome of baby between the study and control Group ( N=40)

Group	Overall Perinatal Outcome
Group	Number	Mean	SD
Study group	40	12.89	2.54
Control group	36	7.55	0.93
T=14.326 (significant level p<0.001)

CONCLUSION:

• Re-enforcement is a powerful tool in promoting the outcome of the baby and bringing down the complications in baby.

• Re-enforcement is an one way of empowering women with adequate knowledge and skills towards self-care.

REFERENCES:

· Carroli G and J Belizan. 2000. Episiotomy for vaginal birth (Cochrane Review), in The Cochrane Library. Issue 2. Update Software: Oxford.

· Eason E et al. 2000. Preventing perineal trauma during childbirth: A systematic review. Obstet Gynecol 95: 464–471.

· Gupta JK and VC Nikodem. 2000. Woman’s position during second stage of labour (Cochrane Review), in The Cochrane Library. Issue 4. Update Software: Oxford.

· L and E Hodnett. 2000. Caregivers' use of strict criteria for diagnosing active labour in term pregnancy (Cochrane Review), in The Cochrane Library. Update Software: Oxford.

· Ludka LM and CC Roberts. 1993. Eating and drinking in labor: A literature review. J Nurse-Midwifery 38(4): 199–207.

· di BC et al. 1999. Effects of female relative support in labor: A randomized control trial. Birth 26:4–10.

· Neilson JP. 1998. Evidence-based intrapartum care: evidence from the Cochrane Library. Int J Gynecol Obstet 63 (Suppl 1): S97–S102.

· World Health Organization Safe Maternal Health and Safe Motherhood Programme. 1994. World Health Organization partograph in management of labour. Lancet 343 (8910):1399–1404.

· World Health Organization (WHO). 1999. Care in Normal Birth: A Practical Guide. Report of a Technical Working Group. WHO: Geneva.

Received on 05.11.2012 Modified on 30.11.2012

Asian J. Nur. Edu. and Research 2(4): Oct-Dec. 2012; Page 222-223