Practices and perceptions influencing maternal health in rural Sindh, Pakistan: a qualitative study

Objective: To assess the status of maternal health awareness and use of antenatal care among young married women. Method: The qualitative study was conducted from August 05 to September 17, 2023, in six villages of northern Sindh after approval from the ethics review board of Shah Abdul Latif University, Khairpur, Pakistan. Data was collected using face-to-face interviews with women who were married and had experienced childbearing in adolescence. The data was subjected to thematic analysis, leading to codes and themes. Results: Of the 37 women, 20(54%) were aged 19-20 years, followed by 9(24%) aged 15-16 years and 8(22%) aged 17-18 years. Age at first pregnancy was 15-16 years in 20(54%) cases and 17-18 years in 17(46%). The participants lacked knowledge about maternal health and antenatal coverage: 18 (49%) women received no antenatal information during the first pregnancy. Social and cultural factors, e.g., age at marriage or lack of education, led to a knowledge gap and posed as barriers to women’s understanding of the importance of antenatal care. Among the participants, 27(73%) reported that their first pregnancy was unplanned. Only 12(32.4%) subjects met the minimum recommended visits of antenatal care, whereas 8(22%) did not have any antenatal care check-ups throughout the pregnancy. Further, 15(40.5%) subjects received health information during the first pregnancy, while the rest relied on intergenerational family guidance based on the belief that pregnancy and childbirth are routine life events. Resultantly, they did not use multivitamins, blood tests or 18 (49%) did not have scans to ensure a healthy pregnancy, and experienced unplanned pregnancy, anaemia, fatigue, weakness, weight-loss and anxiety. Conclusion: Deficient knowledge about the importance of maternal health, particularly during pregnancy, among the subjects was a barrier to smooth antenatal care uptake. There is a need for community-based interventions, particularly in rural areas. Key Words: Maternal health awareness, Antenatal care, Pregnancy, Rural areas, Pakistan.