Awareness on pregnancy risk abysmally low in Meghalaya   

Only 16% pregnant women in East Khasi Hills ‘well prepared’ for childbirth 

ROOPAK GOSWAMI 

Shillong, Feb 6: A new study conducted in East Khasi Hills has revealed concerning gaps in maternal health preparedness in Meghalaya, with just 16% of pregnant women found to be “well prepared” for childbirth and related emergencies, while a staggering 84% were classified as inadequately prepared.

The research, published in the Indian Journal of Medical Research by scientists from the Indian Institute of Public Health (IIPH), Shillong, reported a Birth Preparedness and Complication Readiness (BPCR) Index of only 43.4%, underscoring systemic weaknesses in maternal health awareness and planning.

The study found that awareness of pregnancy danger signs was critically low, with only 5% of pregnant women able to identify at least one danger sign. Emergency arrangements were also found lacking — just 8.5% had arranged a potential blood donor, and only 29% had made transportation arrangements for delivery. 

Notably, none of the observed antenatal care (ANC) visits included counselling on birth preparedness, indicating a gap in communication within the healthcare system.

The findings are particularly concerning for Meghalaya, which recorded 228 maternal deaths in 2021–22 — the highest in the Northeast. 

Health experts note that most maternal deaths are preventable if complications are recognised early and timely medical care is accessed. However, the study indicates that the “three delays” — delay in deciding to seek care, delay in reaching a health facility, and delay in receiving appropriate treatment — continue to hinder maternal outcomes in the state. 

Meghalaya’s difficult hilly terrain, limited road connectivity, and high prevalence of anaemia among women further compound the risks.

Researchers also highlighted the role of social and cultural dynamics. Many women rely on family members for decision-making, while traditional beliefs and preferences for home deliveries continue to influence maternal choices. Community and family support helped some women save money and plan for institutional deliveries. Interestingly, the study observed that cohabiting women were more likely to be better prepared than formally married women, suggesting that local social structures may shape maternal health decisions in unexpected ways.

Routine ANC visits included physical examinations and laboratory tests; however, counselling and communication were limited. Discussions on nutrition and family planning were occasionally mentioned, but birth preparedness was not addressed — a gap the authors describe as a missed opportunity to provide potentially life-saving information.

As one of the first detailed assessments of birth preparedness in Meghalaya, the study brings much-needed data from a region often underrepresented in national research. With maternal mortality remaining a critical concern, the findings send a clear message: medical check-ups alone are not enough — awareness, preparedness, and effective communication could determine whether childbirth is safe or life-threatening.

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