KNOWLEDGE OF CAUSES AND PREVENTIVE MEASURES OF ANTEPARTUM HEMORRHAGE AMONG PREGNANT WOMEN ATTENDING ANTENATAL CLINIC AT COOUTH, ANAMBRA STATE

TOPIC: INFLUENCE OF MOBILE PHONE HEALTH INFORMATION ON ANTENATAL CARE PRACTICES AMONG PREGNANT WOMEN

THIS TOPIC IS ALSO SUITABLE FOR: 
1. Public Health Department

2. Nursing Science Department

3. Health Education Department

4. Community Health Department

This research material contains:

1-Chapter One to Five

2-Recent References/citations

3-Tables/Charts/Graphs in Chapter Four

4-Accurate Data Analysis

5-Table of Contents

6-Questionnare

ABSTRACT
This study was carried out to examine the knowledge of causes and preventive measures of antepartum hemorrhage among pregnant women attending antenatal clinic at COOUTH, Anambra State. The study was specifically carried out to assess the level of knowledge of the causes of antepartum hemorrhage among pregnant women attending antenatal clinic at COOUTH, Anambra State, examine the level of knowledge of the preventive measures of antepartum hemorrhage among pregnant women attending antenatal clinic at COOUTH, Anambra State, assess the preventive practices adopted by pregnant women to reduce the risk of antepartum hemorrhage at COOUTH, Anambra State and determine the factors influencing the adoption of preventive measures against antepartum hemorrhage among pregnant women attending antenatal clinic at COOUTH, Anambra State. The study employed the descriptive research design. Hence, the questionnaire was used for data collection, while the data collected were analyzed using descriptive and inferential statistics comprising frequency tables, percentages and Cross Sectional Chi-square. The study population comprised 250 pregnant women attending antenatal clinic at COOUTH, Anambra State. A sample size of 154 respondents was determined using Taro Yamane formula and selected through a multi-stage sampling technique involving stratified and convenience sampling methods, while 139 validated copies of the questionnaire were used for analysis. From the responses obtained and analyzed, the findings revealed that pregnant women had a moderate level of knowledge of the causes of antepartum hemorrhage, possessed a moderate level of knowledge of its preventive measures, and adopted moderate preventive practices against antepartum hemorrhage. The findings further revealed that health education, healthcare workers' guidance, accessibility of antenatal services, family support and previous pregnancy experiences influenced the adoption of preventive measures. The hypothesis tested using Cross Sectional Chi-square showed a significant relationship between knowledge of the causes of antepartum hemorrhage and the adoption of preventive measures at χ² = 24.63, df = 1, P = .000. The study therefore recommends that healthcare providers should strengthen health education on antepartum hemorrhage during antenatal clinics, while government and hospital management should improve access to quality maternal healthcare services to enhance the adoption of preventive measures among pregnant women.

Keywords: Antepartum Hemorrhage, Knowledge, Preventive Measures, Pregnant Women, Antenatal Clinic.

CHAPTER ONE
INTRODUCTION (Preview)
1.1 Background to the Study
During pregnancy, the health and well-being of women has a significant impact on foetal development, birth outcomes and family life. Pregnancy is a natural physiological phenomenon, yet demands constant medical care and evidence-based health education for a favorable maternal and neonatal health outcomes (Ojukwu et al. (2021). Antenatal care is thus a vital part of the care that mothers receive, and is used to provide regular clinical evaluation, preventative measures and health education throughout the pregnancy. Antenatal care had increased the awareness of the mother to pregnancy-related conditions through organised health education and personalised counseling (Omotayo et al. (2024). In the same vein, Adebiyi et al., (2023) found that quality maternal healthcare had fostered informed decisions and healthy pregnancy practices among women. Gelan et al. (2022) also noted that the regular health education has improved women's knowledge on factors affecting their wellbeing and their baby's wellbeing. However, good level of antenatal service has made a significant impact in the enhancement of maternal health literacy, which in turn has led to safe pregnancy and child delivery in various health care facilities.

Knowledge is still a basic factor in the prediction of health behaviour, as it affects the ability of an individual to identify health-related issues, value related risk factors, and engage in health protective behaviours. For pregnant women, the extent of knowledge is empowering one to be aware of the physiological change if it falls beyond the normal range, thereby, seeking available health services immediately. Antepartum haemorrhage, as normal bleeding from or into the genital tract after the age of fetal viability but before the delivery of fetus, is obstetric condition that needs a lot of attention. Ochieng (2023) reported that antepartum haemorrhage (APH) was a major obstetric complication with consequences for maternal and foetal welfare, and was a condition which required immediate clinical action. Knowledge of antepartum haemorrhage according to Balcha et al., (2023) included knowledge on the causes of antepartum haemorrhage, warning signs of antepartum haemorrhage, precautions to be taken in preventing antepartum haemorrhage, and the importance of seeking prompt medical help when experiencing abnormal vaginal bleeding during pregnancy. Similarly, Bazirete et al. (2022) revealed that maternal health education provided during prenatal care has improved women's understanding of the various complications associated with pregnancy, such as antepartum haemorrhage, which in turn enables them to make informed choices and decisions regarding their health during pregnancy.

Sufficient information on etiology and prevention of antepartum haemorrhage is a crucial part of maternal health education, facilitating preventive health practices and early health-seeking actions. The most common causes of antepartum haemorrhage are placenta previa, placental abruption, uterine abnormalities, trauma and bleeding from lesions of the lower genital tract. These include regular check-ups at the antenatal clinic, prompt identification of obstetric risk factors, adherence to medical advice, good pregnancy habits and prompt reporting of any vaginal bleeding during pregnancy. Adebayo et al. (2024) reported that pregnant women who attended all the antenatal health education were more aware of the practices of preventive maternal health care than the pregnant women who had limited exposure to the education. In the same vein, Sulaiman and Abdullahi (2025) discovered that knowledge on pregnancy complications and preventive behaviours among pregnant women were significantly improved when there was constant contact with healthcare providers. Moreover, Eleje et al., (2025) claimed that the antenatal clinics (ANC) continued to be an effective platform to provide evidence-based information on obstetric conditions through health talks, providing individual counselling and conducting routine clinical assessments, thus improving maternal preparedness for pregnancy and childbirth.

Tertiary healthcare institutions are still a key provider of comprehensive ANC services aimed at improving maternal knowledge and contributing to good outcomes of pregnancies in Nigeria. One of these Institutions is the Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Anambra State, one of the teaching hospitals where specialized maternal health care services are provided to pregnant women from varying educational, cultural and socioeconomic backgrounds. The hospital has an antenatal clinic that offers organized health education, follow-up obstetric checkups, and counseling to help pregnant women gain valuable insights into pregnancy and related complications. Eleje et al. (2025) indicated that maternal healthcare delivery continued to improve by tertiary health institutions who incorporate comprehensive health education during routine provision of maternal healthcare. In the same vein, Ojukwu et al. (2021) noted that maternal education has taken a centre stage in health care facilities in southeast Nigeria as a central approach to improve pregnancy outcomes. Therefore, a study on the knowledge of the causes and preventive measures of antepartum haemorrhage among pregnant women attending COOUTH, Anambra State, would provide a useful base line information towards understanding maternal health education in this health care setting.

1.2 Statement of the Problem

Maternal health education is part of the process of providing antenatal care, as it is essential to pass on to pregnant women the information they need to have a healthy pregnancy and to make informed decisions about health care. Expectant mothers should receive sufficient information during routine antenatal services on pregnancy related conditions, their causes, warning signs and appropriate means of prevention. This information helps them identify abnormalities early on, and get prompt medical care when needed. Based on the findings of Omotayo et al. (2024), the role of antenatal care in promoting maternal health literacy, particularly in the area of structured education and counselling, has remained largely unchanged. Moreover, the findings showed that the health education integrated into Antenatal Services had positively enhanced preparedness of mothers for pregnancy and childbirth (Eleje et al. (2025). All pregnant women attending an antenatal clinic should have a reasonable knowledge of common obstetric conditions such as antepartum haemorrhage (APH) and they should be aware of the preventive actions they can take to ensure good maternal and fetal outcomes.

Although health education is offered during the antenatal care service, the knowledge of antepartum haemorrhage, its causes and prevention among pregnant women has been inconsistent. Inadequate knowledge of the condition, combined with limited knowledge on causes, warning signs and prevention practices creates disparities in maternal health awareness among some pregnant women. Ochieng (2023) revealed that despite the pregnant women's regular attendance at ANCs, there had been variations in their knowledge of antepartum haemorrhage. Likewise, the difference in the level of women's knowledge about preventive health care during pregnancy was attributed to maternal health education (Adebayo et al. (2024). Antenatal clinic attendees should be knowledgeable enough about antepartum haemorrhage and the way to prevent it. But there is evidence that this expectation has not always been realised; further research is needed of mothers' knowledge in particular health care settings.

While there are studies on maternal health education and pregnancy related complications, few studies have been conducted on attitude of pregnant mothers towards the knowledge of the cause and prevention of antepartum haemorrhage among pregnant women attending the antenatal clinic of Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Anambra State. Many studies have focused on maternal health problems in larger populations, but they have not included sufficient evidence from the healthcare facility to be relevant to this current study. Gelan et al. (2022) indicated that maternal knowledge had remained as one of the important factors for having positive pregnancy outcomes. Similarly, Adebiyi et al. (2023) highlighted the need for evidence-based data to enhance maternal health education initiatives in context. This gap in the knowledge calls for the present study which aims at evaluating the knowledge of the causes and preventive measures of antepartum haemorrhage among pregnant women attending the antenatal clinic in COOUTH, Anambra state. The results will be used to give evidence which can help improve the provision of health education and maternal health care in the study area.

1.3 Objective of the Study

The main purpose of this study is to assess knowledge of causes and preventive measures of antepartum hemorrhage among pregnant women attending antenatal Clinic at COOUTH, Anambra State. The specific objectives of the study seek to:

1.Assess the level of knowledge of the causes of antepartum hemorrhage among pregnant women attending antenatal clinic at COOUTH, Anambra State.

2.Examine the level of knowledge of the preventive measures of antepartum hemorrhage among pregnant women attending antenatal clinic at COOUTH, Anambra State.

3.Assess the preventive practices adopted by pregnant women to reduce the risk of antepartum hemorrhage at COOUTH, Anambra State.

4.Determine the factors influencing the adoption of preventive measures against antepartum hemorrhage among pregnant women attending antenatal clinic at COOUTH, Anambra State.

Other parts of chapter one include:
1.4 Research Questions

1.5 Research Hypotheses

1.6 Significance of the Study

1.7 Scope of the Study

1.8 Operational Definition of Terms

CHAPTER TWO
REVIEW OF LITERATURE (Preview)
This chapter critically examines relevant literature that would assist in explaining the research problem and, furthermore, recognizes the efforts of scholars who had previously contributed immensely to similar research. The chapter intends to deepen the understanding of the study and close the perceived gaps. This chapter therefore focuses on the concept of antepartum haemorrhage, awareness about antepartum haemorrhage among pregnant women, knowledge of the preventive measures of antepartum haemorrhage among pregnant women, etc. The chapter is sub-grouped into the following major headings:
Conceptual Framework

Theoretical Framework

Empirical Review

Summary of Literature Review

CHAPTER THREE
METHODOLOGY (Preview)
Presented below is a snapshot of key areas of the study methodology, the full and detail chapter three methodology is contained in the instant download document.

Research Design: The study adopted a quantitative research approach.

Population of the Study: The population of the study comprises pregnant women attending the antenatal clinic at Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Anambra State.

Sample Size Determination: The study adopted the Taro Yamane formula to determine a sample size of 154 participants.

Sampling Technique: The study employed a multi-stage sampling technique involving stratified and convenience sampling methods to select the individual respondents.

Research Instrument: The study utilized a structured questionnaire as the instrument for data collection.

Methods of Data Analysis: The collected data were analyzed using frequencies and percentages to summarize and present the demographic characteristics of the respondents and their opinions. Inferential statistics, particularly Cross-sectional Chi-square, were used to test the hypotheses. The data were analyzed using SPSS, and the results were presented in tables, charts, and graphs.
Full outline for chapter three;
3.1 Research Design

3.2 Research Setting 

3.3 Population of the Study

3.4 Sample Size

3.5 Sampling Technique

3.6 Instrument for Data Collection

3.7 Validity of the Instrument

3.8 Reliability of the Instrument

3.9 Method Of Data Collection

3.10 Method of Data Analysis

3.11 Ethical Consideration

CHAPTER FOUR: RESULTS
MAJOR FINDINGS (Preview)
The analysis results were presented in tables and charts. Based on the results obtained from the analysis, the following major findings were made:

i. The study found that the level of knowledge of the causes of antepartum hemorrhage among pregnant women attending antenatal clinic at COOUTH is moderate to high, as evidenced by a grand mean of 3.49, with item means ranging from 3.37 to 3.61, above the acceptance benchmark of 3.00. This implies that most of the women know that placental problems, abdominal trauma, high blood pressure and previous pregnancy complications can cause antepartum hemorrhage.

ii. The study found that the level of knowledge of the preventive measures of antepartum hemorrhage among the women is moderate to high, as evidenced by a grand mean of 3.55, with item means ranging from 3.40 to 3.73, above the acceptance benchmark of 3.00. This implies that most of the women know the importance of regular antenatal attendance, medical check-ups, prompt reporting of bleeding and adherence to health workers’ instructions.

iii. The study found that the women adopt preventive practices against antepartum hemorrhage, as evidenced by a grand mean of 3.60, with item means ranging from 3.40 to 3.77, above the acceptance benchmark of 3.00. This implies that most of the women attend antenatal clinic regularly, seek medical attention for bleeding and follow health workers’ advice.

iv. The study found that several factors influence the adoption of preventive measures among the women, as evidenced by a grand mean of 3.57, with item means ranging from 3.41 to 3.76, above the acceptance benchmark of 3.00. This was further confirmed by the result of the corresponding hypothesis test, which showed a Chi-square value (χ²) of 24.63 and p-value of 0.000 (p < 0.05), leading to the rejection of the null hypothesis. This implies that knowledge of the causes of antepartum hemorrhage is significantly related to the adoption of preventive measures.

CHAPTER FIVE: DISCUSSION, CONCLUSION AND RECOMMENDATION
This chapter covers the following outline:

5.1 Discussion of Findings    

5.2 Implications of the findings

5.3 Limitations of the Study

5.4 Summary

5.5 Conclusion

5.6 Recommendations

5.7 Suggestions for Further Studies 

Reference
Appendix

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