INTRODUCTION:

Pregnancy is a normal physiologic event. Pregnancy is a time of joy and celebrations, a time of congratulations, good wishes. Pregnancy links mother and fetus together and is the basis for regenerating the generations. Most pregnancies end with birth of a live baby to a healthy mother. For some, however child birth is not the joyous event, but a time of pain, fever, suffering and even death. Blume in an article says that watchful waiting, emotional support and parental education on recognition of warning signs are important during pregnancy.

This enables the women to guide and regulate their own health practices and prevent complication. Every complication will be followed by warning signs. The pregnant women must also be wise to be aware of any signs of trouble. When the unexpected occurs, she may need prompt treatment to protect the baby⁸.

Nature has bestowed a woman with the capability of producing children, the process that makes her mother. But sad part is that, this normal life furthering process of procreation can lead to as grim a situation as death. At least 40% of all pregnant women will experience some type of complications during their pregnancies. For about 15%, these complaints will be potentially life threatening, and will require immediate obstetric care. Maternal death also compromises, the health and survival of infants and children they have behind. The death of a woman during pregnancy and childbirth is not only a health issue but also a matter of social injustice².

Focus group discussions conducted with women in semi-urban community of Ekpoma, Nigeria in 15 focus groups with the aim of examining the factors responsible for delaying or preventing effective care and treatment for women with pregnancy related complications. The study area contained 14 modern health institutions, two state controlled hospitals. That population was lacking in knowledge about the warning signs and potential dangers and women did not know about when to seek help from modern obstetric services. They concluded that women need to be educated about the warning signs during pregnancy and delivery and the importance of seeking care early⁴.

Some of the warning signs of pregnancy are light or heavy vaginal bleeding, cramping, high blood pressure, lack of kicking, brick red vaginal discharge, severe constant headache, blurring vision, fever over 101degree Fahrenheit, severe nausea and vomiting, burning sensation or pain when urinating, any blow or injury to the lower abdomen with or without pain, sharp upper-to mid-abdominal pain, swelling or puffiness of the hands, face and eyes, sudden noticeable weight gain not related to eating, a sudden increase in thirst accompanied by little or no urination, fainting or dizziness, all-over itching and you just “don’t feel right”¹¹.

A study conducted on the assessment of knowledge, attitude and practices of pregnant women on selected aspects of antenatal care around the world highlighted that, every minute, a woman dies as a result of complications related to pregnancy of children in this world and nearly half a million women die every year the world over⁵.

A discussion in identifying available technologies for antenatal care and points where new and improved ones are needed reviewed and concluded that an important aspect of basic antenatal health care is advice on how pregnant women can stay healthy. The importance of a good diet should be emphasized, and pregnant women should also be taught ways to prevent or relieve the minor discomforts of pregnancy. Women should be informed about which conditions are normal during pregnancy and which the signs of danger are; they should always be checked for signs of immediate danger so that early or emergency treatment can be provided. The major emphasis of antenatal care is similar throughout the developing world, yet each country needs to develop its own strategy, it may also be necessary to develop individual approaches for different regions within a country¹⁰.

MATERIALS AND METHODS:

Materials:

The Structured Teaching Programme was developed which was of one hour duration and covered the following areas, Meaning about the pregnancy and warning signs, List of warning signs, Identification of warning signs and its management, Importance of care during pregnancy. Posters were used to describe of the warning signs of pregnancy include vaginal bleeding, severe vomiting, swelling of the face, arms and legs not relieved after rest, high fever, decreased fetal movements, pallor or pale nail beds, lips and tongue (anemia), severe headache, leaking of watery fluid through vagina (rupture of membranes), abdominal pain. Handouts were used for explaining the importance of care during pregnancy.

Methods:

A pre-experimental study with one group pre-test, post-test design was adopted for the study. The sample consisted of 60 primigravida women from a selected maternity hospital selected by purposive sampling technique. On the first day the pre-test was conducted by administering a self structured knowledge questionnaire after taking informed consent and after which the STP was administered. The post-test was conducted on the 7^th day on the same primigravida women, with the same tool in order to assess the gain in knowledge score. Structured questionnaire included demographic data and knowledge questionnaire on warning signs of pregnancy.

RESULT:

The study reveals that majority of the primigravida mothers (75%) were below 19-21years age group. Pre-test score revealed 100% had inadequate knowledge on warning signs of pregnancy. Post-test score revealed 16.67% had inadequate knowledge and 83.33% had adequate knowledge on warning signs of pregnancy. Pre-test mean percentage was found to be 40.63% with a standard deviation of 1.46. Post-test mean percentage was found to be 78.50% with a standard deviation of 8.64. Overall mean score in the post test was 39.25; whereas, the pre-test mean score were 20.32 showed significant increase in knowledge of the primigravida women regarding warning signs of pregnancy after their exposure to the structured teaching programme. Paired t test was used to find the significant difference between the overall pre-test and pos-test knowledge scores which showed that the t value 16.827 was significant at P<0.01.

Cone diagram shows the effectiveness of the structured teaching programme by comparing the pre-test and post-test knowledge mean scores.

The Fisher’s exact probability value of type of family is significant when compared to the table value at 0.05% level of significance. Chi-square value of type of educational status and occupation is significant when compared to the table value at 0.05% level of significance, indicated that there is significant association between the type of family, educational status and occupation and the pre-test knowledge scores among primigravida women. (Significant)

The Fisher’s exact probability value of age is significant when compared to the table value at 0.05% level of significance. Chi-square value of type of religion, family income and source of information is not significant when compared to the table value at 0.05% level of significance, indicated that there is no significant association between the age, religion, family income and source of information and the pre-test knowledge scores among primigravida women. (Not significant). The Fisher’s exact probability value of age, type of family, religion, educational status and chi-square value of family income, occupation and source of information is not significant when compared to the table value at 0.05% level of significance, indicated that there is no significant association between the age, type of family, religion, educational status, family income, occupation and source of information and the post-test knowledge scores among primigravida women. (Not significant).

DISCUSSION:

In the Present study, Pre-test score revealed 100% had inadequate knowledge on warning signs of pregnancy. Post-test score revealed 16.67% had inadequate knowledge and 83.33% had adequate knowledge on warning signs of pregnancy, findings were supported by a study done by Judith Naronha, who assessed the learning needs of primigravida women and found that the mean post-test score of 88.85% was significantly higher than the mean pre-test knowledge score of 55%.

The study showed that the t value 16.827 was significant at 0.1% level of significance between the overall pre-test and pos-test knowledge scored and that difference was due to the exposure of the primigravida women to structured teaching programme on warning signs of pregnancy which is is congruent with the study done by Mrs. Radhika, on effectiveness of structured teaching programme in knowledge regarding selected warning signs of pregnancy. Based on this study the findings showed that structured teaching programme has a significant effect in improving knowledge of primigravida antenatal mothers on warning signs of pregnancy.

The present study indicate that all health members should be made aware of the need of observing, supervising, teaching and improving the knowledge regarding warning signs of pregnancy. The educative role of the nurses could be implemented in the nursing practice. The commonly occurring warning signs and safe measures to reduce warning signs will enlighten the community nursing practice to design and formulate mass health education programme. Health education can be imparted through mass media i.e., through radio, television, documentary films, pamphlets, poster and information booklets etc. The health personnel can take initiative in directing the mass about healthy practices, which can be better understood by the pregnancy women, the family members and the community at large.

CONCLUSION:

Gradually the people views can change from wrong, unhealthy perception and practices to healthy practices through education. The goal of nursing practice is to increase the knowledge of the people and to promote healthy hood by providing good education and services. The following conclusions were made on the basis of the findings of the study:

1. Present study shows that there is poor knowledge regarding warning signs of pregnancy among primigravida women.

2. Analysis shows that there is a significant association between the knowledge and the demographic variables like age, type of family, religion, area of residence, educational status family income, occupation and source of information.

3. It concludes that there is no significant association between the knowledge and age, religion, family income and source of information.

CONFLICT OF INTEREST:

The authors have no conflicts of interest regarding this investigation.

ACKNOWLEDGMENTS:

The author would like to thank all for support in conducting the research.

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Received on 28.08.2024 Revised on 23.12.2024

Accepted on 05.03.2025 Published on 17.05.2025

Available online from May 20, 2025

Int. J. Nursing Education and Research. 2025;13(2):112-116.

DOI: 10.52711/2454-2660.2025.00023

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.

Component	Observation	Mean	Mean percentage	Standard deviation	Mean difference	t value	Inference
Overall knowledge	Pre test	20.32	40.63	1.46	18.93	16.827	HS
Overall knowledge	Post test	39.25	78.50	8.64	18.93	16.827	HS