Rural Indian Women Speak: Insights on Maternal Health Literacy and Access Gaps Regarding Obstetric Emergencies

Abstract

Abstract Background: 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. Objectives: The present study aimed to assess the knowledge of obstetric danger signs among pregnant women in rural Gujarat and explore the associated sociodemographic and obstetric history factors. Qualitative methods further elucidated the experiences, attitudes, and perceptions underlying maternal health literacy. Methods: A mixed-methods study was conducted among 390 antenatal women selected through multistage sampling from 6 community health centres in the Jamnagar district. A structured questionnaire and in-depth interviews were used for data collection. Quantitative data were analysed via regression modelling, and qualitative data were thematically analysed. Results: Among the 390 patients, the majority correctly identified pregnancy bleeding (73.3%, n=286), leakage of fluid (71%, n=277), and swelling (74.3%, n=290) as danger signs. Approximately 54.8% (n=214) had good knowledge of dangersigns. Knowledge was significantly greater among women aged >25 years (AOR 3.11, 95% CI 2.02-4.7), among literate women (AOR 2.14, 95% CI 1.12-4.08), among those counselled during ANC (AOR 2.2, 95% CI 1.2-8.1) and among those counselled during 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. Conclusion: Despite interfacing with health services, awareness of obstetric danger signs was incomplete among rural antenatal women. Tailored education through enhanced counselling and family-centered care can improve maternal health literacy.