Аssessing maternal readiness for infant care: supporting postnatal services (Bulgaria, 2022-2023)

Abstract Background High-quality prenatal and postnatal care is essential for improving child health outcomes and reducing infant mortality, which continues to be an important public health problem in Bulgaria. The aim of this study was to assess the quality and impact of prenatal and postnatal healthcare services (women's consultation, maternity ward, children's consultation) on maternal readiness for early childcare. Methods A 30-item questionnaire was developed with expert input and piloted for clarity. Data were collected anonymously from 249 mothers of children under one year using online platforms. The survey explored prenatal support, postnatal care, family help, and maternal knowledge. Descriptive and comparative methods were used. Accepted level of significance was p < 0,05. Data processing was performed by IBM SPSS Statistics v.23. Results Although 94% of mothers attended regular prenatal consultations, 76% received no advice on newborn care. Medical guidance was largely limited to delivery itself, with most support focusing on physical preparation, while only 25% felt psychologically ready. Information about feeding, hygiene, and routines was often lacking. Non-medical sources, such as family and media, were more frequently used than professional advice. Breastfeeding education in hospitals was limited, and 30% of mothers received no guidance at discharge. Despite national guidelines, 14% of newborns were not visited at home after hospital discharge, contrary to the recommendations of Bulgaria's National Maternal and Child Health Program. Conclusions Maternal services in Bulgaria show strong clinical coverage but insufficient educational support. Identified gaps in maternal readiness, especially in feeding, care routines, and parental confidence, highlight the need for structured health education. Developing a tool may support ongoing monitoring and target interventions to improve outcomes, potentially mitigating postpartum distress in unprepared mothers. Key messages • Strengthening maternal education during prenatal and postnatal care is vital for confident early parenting and healthier child development. • Monitoring maternal readiness helps design targeted interventions and may prevent postpartum challenges in vulnerable families.