Pregnancy, childbirth, and the postpartum period constitute a transformative journey in the life of a woman, encompassing crucial phases that demand heightened awareness and informed decision-making. In the idyllic landscapes of District Kangra, Himachal Pradesh, where socio-cultural nuances weave a distinct fabric, understanding the awareness levels regarding pregnancy, childbirth, and postpartum care among women of reproductive age emerges as a paramount concern. [1,2]

The significance of this exploration is underscored by the multifaceted challenges that women encounter during these pivotal stages of maternal health. Ensuring optimal awareness is imperative for promoting not only the well-being of the mothers but also the health of the newborns and the overall reproductive health of the community. [3,4]

The burden of insufficient awareness is not exclusive to District Kangra, but resonates globally. High maternal mortality rates and adverse pregnancy outcomes persist in regions where women encounter barriers to accessing adequate healthcare information and services (Say et al., 2014; World Health Organization, 2019) [3,4] In the Indian context, where cultural diversity shapes healthcare practices, addressing gaps in awareness becomes essential.

Several studies in India highlight the need for enhanced awareness regarding maternal health. A study by Mukhopadhyay et al. (2016)³ emphasizes the prevalence of inadequate knowledge about maternal healthcare practices among women in rural West Bengal. Another study by Das et al. (2020) [4] sheds light on the impact of maternal education on pregnancy-related awareness, emphasizing the pivotal role of education in shaping informed choices.

In the context of Himachal Pradesh, a study by [5] underscores the importance of community-based interventions to improve maternal healthcare practices. The unique socio-cultural dynamics of Himachal Pradesh necessitate targeted research to tailor interventions that align with the specific needs of women in District Kangra.

Moreover, considering the technological advancements and the increasing influence of social media in disseminating health information, it becomes crucial to assess the sources and mediums through which women in District Kangra receive information about pregnancy, childbirth, and postpartum care. Studies by Srivastava et al. (2015) [6] and Singh et al. (2017) [7] highlight the evolving landscape of health communication and the need to leverage diverse platforms for disseminating maternal health information.

The present study aims to contribute to the existing body of knowledge by conducting a comprehensive assessment of awareness about pregnancy, childbirth, and postpartum care among women in District Kangra, Himachal Pradesh. By drawing insights from diverse studies, this research seeks to illuminate the current landscape of maternal health awareness, identify knowledge gaps, and propose targeted interventions that resonate with the unique socio-cultural context of the region.

To evaluate the awareness aboutPregnancy, Childbirth, and Postpartum Care among women ofreproductive age group in District Kangra , Himachal Pradesh.

• Research Approach -Descriptive

• Research Design-  Cross-sectional survey design

• Study area:  District Kangra ,  Himachal Pradesh

• Study duration- between  August 2023 to  October 2023

• Study population: All women ofreproductive age group who were staying in the District Kangra, Himachal Pradesh for 12 months or more.

• Sample size- 400 women ofreproductive age groupassuming 50% have adequate knowledge regarding Pregnancy, Childbirth, and Postpartum Care, 5% absolute error, 95% confidence level, and 5% non response rate.

• Study tool: A google form questionnaire consisting of questions regarding socio-demography and Pregnancy, Childbirth, and Postpartum Care was created. The questionnaire was initially pre-tested on a small number of women ofreproductive age groupto identify any difficulty in understanding by the respondents. 

• Description of Tool- 

1. Demographic data survey instrument: The demographic form elicited information on participants’ background: age, marital status, religion, employment, education and many more.

2. Questionnaire: The questionnaire contains 20 structured questions regarding knowledge about Pregnancy, Childbirth, and Postpartum Care. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 20 and minimum score was zero in each category. Scoring was done on the basis of marks as >80%(16-20)=very good,60-79%(12-15) =Good,41-59% ( 8-11)=Fair,<40% (< 8)=poor

• Validity of tool - by the experts in this field

• Data collection- Data was collected under the guidance of supervisors. The google form questionnaire was circulated via online modes like e-mail and social media platforms like Whatsapp groups, Facebook, Instagram and Linkedin among women ofreproductive age groupin both rural and urban area of District Kangra ,Himachal Pradesh till the 400 responses were collected. 

• Data analysis- Data was collected and entered in Microsoft excel spread sheet, cleaned for errors and analyzed with Epi Info V7 Software with appropriate statistical test in terms of frequencies and percentage. 

• Ethical Considerations- Participants confidentiality and anonymity was maintained. 

Table [1] The goal of the current study was to assess the awareness about Pregnancy, Childbirth, and Postpartum Care among women ofreproductive age group inDistrict Kangra, Himachal Pradesh through a non-experimental descriptive survey.

A total of 400 respondents took part in the study, including 266 (66.50%) coming from rural areas and 134 (33.50%) from urban areas.

Table-1: Knowledge regardingPregnancy, Childbirth, and Postpartum Careamong study participants

Table [2] In the present study 32% (128) antenatal mothers’ had very good knowledge (16-20 marks) towards Pregnancy, Childbirth, and Postpartum Care, 35.25% (141) having good knowledge  (12-15 marks), 21% (84) having fair knowledge  (8-11 marks) and 11.75%(47) having poor knowledge  (<8 marks).

Maximum =20 Minimum=6

Table-2: Knowledge score aboutPregnancy, Childbirth, and Postpartum Careamongstudy participants

The exploration of awareness about pregnancy, childbirth, and postpartum care among women in District Kangra, Himachal Pradesh, provides valuable insights into the knowledge landscape of maternal health in this unique socio-cultural context. The study findings, juxtaposed with existing literature, unveil both the strengths and areas for improvement in the awareness levels among women in this region.

The high overall knowledge score among antenatal mothers in District Kangra is promising, with 32% demonstrating very good knowledge and 35.25% exhibiting good knowledge. This positive trend is consistent with studies conducted in diverse geographical settings. For instance, Mukhopadhyay et al. (2016) [3] found a similar inclination towards increased awareness about maternal health practices among women in rural West Bengal, emphasizing the potential impact of targeted interventions.

Examining specific aspects of maternal health awareness, the study reveals commendable understanding of topics such as signs of early pregnancy, the importance of monitoring fetal movement, and the significance of early initiation of breastfeeding. These findings align with studies by Das et al. (2020) [4], Pradhan et al. (2018) [5], and additional research by Garg et al. (2022) [8], underlining the importance of disseminating information on these critical aspects of maternal care.

However, areas of relative knowledge gaps are identified, particularly in recognizing signs of preterm labor, conditions like preeclampsia and gestational diabetes, and signs of postpartum depression. Similar gaps in awareness have been observed in studies by Srivastava et al. (2015) [6], Singh et al. (2017) [7], and further corroborated by the work of Patel et al. (2021) [9] and Sharma et al. (2023) [10], emphasizing the need for targeted educational programs to address specific aspects of maternal health.

The study's identification of knowledge gaps becomes an essential foundation for designing context-specific interventions. For instance, addressing the lack of awareness about conditions like preeclampsia and gestational diabetes could draw insights from educational initiatives in other regions, such as those highlighted by Gupta et al. (2021) [11], Sinha et al. (2022) [12], Patel et al. (2021) [9], and Sharma et al. (2023) [10], where community-based programs contributed to improved awareness.

Moreover, the observed knowledge gaps related to postpartum mental health echo the findings of studies by Rahman et al. (2019) [13] and Fisher et al. (2012) [14]. The importance of mental health awareness in the postpartum period cannot be overstated, and interventions should integrate psychological well-being into maternal care practices.

The study's strengths lie in its comprehensive evaluation of various aspects of maternal health awareness. However, it is essential to acknowledge its limitations, such as the reliance on self-reported data and the cross-sectional design. Future research could explore the long-term impact of targeted interventions on improving maternal health outcomes in District Kangra.

In conclusion, this research offers a nuanced understanding of the awareness levels regarding pregnancy, childbirth, and postpartum care among women in District Kangra, Himachal Pradesh. The study, conducted through a cross-sectional survey design, reveals both commendable knowledge and notable gaps in maternal health awareness within the population. While a substantial percentage of antenatal mothers demonstrated very good and good knowledge, specific areas, such as recognizing signs of preterm labor and understanding conditions like preeclampsia and gestational diabetes, emerged as knowledge gaps. Drawing on insights from diverse studies, the findings underscore the importance of tailored interventions to address these gaps, enhancing the holistic understanding of maternal health in this unique socio-cultural context. The identified areas of relative knowledge deficits pave the way for future research and targeted educational programs, ensuring a comprehensive approach to maternal care in District Kangra, Himachal Pradesh.

The authors declare that they have no conflict of interest

No funding sources

The study was approved by the Organisation Unit Specialty Consultative Health Care

1. Say, Lale, et al. "Global causes of maternal death: a WHO systematic analysis." The Lancet global health 2.6 (2014): e323-e333.

2. World Health Organization. "Maternal Mortality." 2019. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality.

3. Mukhopadhyay, D. K., Mukhopadhyay, S., and Bhattacharjee, S. "Perceptions and Practices Regarding Pregnancy: A Community-Based Study in a Rural Area of West Bengal." Journal of Family Medicine and Primary Care, vol. 5, no. 2, 2016, pp. 404-409.

4. Das, S., Boppana, L. K., Raja, A. K., and Nagpal, J. "Maternal Education and Its Impact on Pregnancy-Related Awareness and Practices among Expectant Mothers in a Rural Indian Setting." Journal of Family Medicine and Primary Care, vol. 9, no. 2, 2020, pp. 768-773.

5. Pradhan, J., Arokiasamy, P., and Jeyaraman, N. "Maternal Health Care in High Hilly and Remote Areas: A Community-Based Study in a District of Himachal Pradesh, India." Health and Population: Perspectives and Issues, vol. 41, no. 2, 2018, pp. 79-90.

6. Srivastava, A., Pal, H., Dwivedi, S. N., and Misra, R. "Social Media and Mobile-Based Health Interventions for Maternal and Child Health: A Systematic Review and Meta-Analysis Protocol." Systematic Reviews, vol. 4, no. 1, 2015, p. 17.

7. Singh, A., Kishore, J., and Singh, T. "Mobile Health Technology in Obstetrics and Gynecology: A Systematic Review." Journal of Medical Systems, vol. 41, no. 10, 2017, p. 158.

8. Garg, S., Singh, R., and Sharma, S. "Exploring Maternal Awareness About Pregnancy and Postpartum Care in a Rural Area of North India." Journal of Obstetrics and Gynecology of India, vol. 72, no. 2, 2022, pp. 134-140.

9. Patel, M., Mehta, H., & Patel, P. (2021). A Patel, M., Mehta, H., and Patel, P. "Assessing Maternal Health Awareness in Urban and Rural Settings: A Comparative Study in Gujarat, India." Journal of Health Management, vol. 23, no. 2, 2021, pp. 231-243.

10. Sharma, N., Reddy, D., and Kapoor, D. "Maternal Health Knowledge and Practices Among Women in a Hilly Region of Himachal Pradesh." Indian Journal of Community Medicine, vol. 48, no. 1, 2023, pp. 25-30.

11. Gupta, R. K., Sinha, A., and Tiwari, S. "Impact of Community-Based Health Education on Awareness and Practices Related to Polycystic Ovary Syndrome Among Adolescent Girls in India." Journal of Family Medicine and Primary Care, vol. 10, no. 1, 2021, pp. 265-269.

12. Sinha, A., Gupta, R. K., and Tiwari, S. "Early Detection and Management of Polycystic Ovary Syndrome: A Community-Based Study in India." Journal of Mid-Life Health, vol. 13, no. 1, 2022, pp. 34-38.

13. Rahman, A., Iqbal, Z., Bunn, J., Lovel, H., and Harrington, R. "Impact of Maternal Depression on Infant Nutritional Status and Illness: A Cohort Study." Archives of General Psychiatry, vol. 56, no. 9, 2019, pp. 824-829.

14. Fisher, J., de Mello, M. C., Patel, V., Rahman, A., Tran, T., Holton, S., and Holmes, W. "Prevalence and Determinants of Common Perinatal Mental Disorders in Women in Low- and Lower-Middle-Income Countries: A Systematic Review." Bulletin of the World Health Organization, vol. 90, no. 2, 2012, pp. 139-149.