Comparative study of knowledge, attitude and practice of birth preparedness and complication readiness among primigravida and multigravida women: A prospective study

Background: Birth Preparedness and Complication Readiness (BPCR) is a key strategy promoted to reduce maternal and neonatal morbidity and mortality, particularly in low- and middle-income settings. Adequate knowledge, positive attitude, and appropriate practices related to BPCR enable timely decision-making and access to skilled obstetric care. Gravidity status plays an important role in shaping women’s awareness and behaviors during pregnancy. However, comparative evidence between primigravida and multigravida women in Central Maharashtra remains limited. Objectives: To comparatively assess the knowledge, attitude, and practice of birth preparedness and complication readiness among primigravida and multigravida women attending antenatal care services in Central Maharashtra. Methods: This prospective, observational study was conducted over a period of one year from January 2025 to December 2025 in selected antenatal clinics of Central Maharashtra. A total of 100 pregnant women were enrolled using a convenient sampling technique, comprising equal proportions of primigravida and multigravida women. Data were collected using a pretested, structured questionnaire covering socio-demographic characteristics and standardized BPCR components, including identification of danger signs, planned place of delivery, skilled birth attendance, transportation arrangements, financial preparedness, and blood donor identification. Knowledge, attitude, and practice scores were calculated and compared between the two groups using appropriate statistical tests. Results: Multigravida women demonstrated significantly higher overall knowledge and practice scores related to BPCR compared to primigravida women. Awareness of obstetric danger signs, prior arrangement of transportation, and financial planning for delivery-related emergencies were more commonly observed among multigravida participants. Although attitude toward institutional delivery and emergency preparedness was generally positive in both groups, primigravida women showed comparatively lower confidence in recognizing complications and initiating timely care-seeking. Previous pregnancy experience was found to be a significant factor influencing BPCR practices. Conclusion: The study highlights notable differences in BPCR knowledge and practices between primigravida and multigravida women, with primigravida women being relatively less prepared for childbirth and obstetric emergencies. Strengthening focused antenatal counseling, especially for first-time mothers, is essential to improve BPCR indicators and promote safe motherhood in Central Maharashtra.