Couple Counsellling on Birth Preparedness and Pregnancy Outcomes in a Family Practice Setting in Northern Nigeria

Abstract

Background: Birth preparedness and complication readiness (BPCR) is an evidence- based approach to reduce delays in accessing skilled maternal and neonatal interventions to reduce morbidity and mortality. Couple counselling aims to involve the partners in joint healthcare decision making. The study set out to determine what effect couple counselling on BPCR had on feto- maternal outcomes in pregnant women.

Methodology: A total of 102 primigravidae were randomized into the intervention group (who had focused BPCR counselling with their partners) and the control group, who had treatment as usual (TAU) ie usual antenatal care. They were followed up till delivery. Data were collected using interviewer administered structured questionnaires and a review of medical records. The primary maternal outcomes were the mode of delivery and occurrence of perinatal complications, while secondary outcomes were the length of hospital stay and presence of maternal mortality. The primary fetal outcomes were the gestational age at birth, and the APGAR score while secondary outcomes were the need for hospital admissions and neonatal mortality. Data were analyzed using SPSS version 25. Comparative analyses were performed using Chi-square test and Fisher's exact test.

Results: The mean ages of the study participants were 22.89 ± 3.7 years for the intervention group, and 22.62 ± 3.9 years for the control group. Although more participants in TAU had unfavourable maternal outcomes such as delivering at home (p= 0.653), having caesarean delivery (p= 0.355), post-partum haemorrhage (p= 0.319), prolonged hospital stay (p= 0.116), only genital tract laceration (p= 0.007) was statistically significant. There was no maternal mortality.
The foetal complications such as LBW (p= 0.041), neonatal admissions (p= 0.041), and pre- term delivery (p= 0.007) were also more in the TAU group as compared to the intervention group. There was one perinatal mortality from the TAU group, and none from the intervention group.

Conclusion: Couple counselling on BPCR significantly improved maternal and foetal pregnancy outcomes. A structured birth preparation counselling with involvement of the male partners should be integrated into routine antenatal care.