INTRODUCTION:

Pregnancy is a super experience introduced by the nature for a women and special event of happiness, expectancy, excitement, anxiety and fear. Every pregnancy is a precious moment for every mother who wants to give safe birth and a healthy child¹.

Primigravida mothers, those experiencing their first pregnancy, often face unique challenges and anxieties regarding childbirth. Understanding the process of labor, delivery, and postpartum care is crucial for their well-being and the safety of their babies. The aim of the study was to determine the effectiveness of STP and SIM on knowledge regarding birth preparedness among the two groups; and compare the effectiveness of STP and SIM on knowledge regarding birth preparedness among the two groups.

Globally, ensuring safe and healthy pregnancies remains a major public health priority. According to the World Health Organization (WHO), antenatal care is essential identify and manage potential complications, promote healthy behaviours, and provide critical interventions such as immunizations, nutritional supplements, and health education (WHO, 2016)². The quality and accessibility of maternal healthcare during pregnancy significantly influence birth outcomes, maternal survival, and long-term health for both mother and child. So now -a-days in maternity hospitals they are giving more importance to birth preparedness. Birth preparedness and complication readiness (BPCR) is a comprehensive strategy aimed at reducing maternal and neonatal morbidity and mortality by ensuring that women and their families are prepared for childbirth and potential obstetric emergencies. This approach encompasses planning for a skilled birth attendant, identifying a health facility, arranging transport, saving money for delivery- related costs, and recognizing danger signs during pregnancy, childbirth, and the postpartum period³.

A study conducted by C. Muthulakshmi and Kotagram Purnesh Yadhav (2024) at SMCH, Chennai, assessed the effectiveness of a structured teaching program on birth preparedness among primigravida mothers. The findings showed a significant improvement in knowledge after the intervention, with 70% of participants scoring in the “adequate” knowledge category post-test compared to only 20% in the pre-test⁴.

Moreover, integrating BPCR into antenatal care enhances communication between health providers and pregnant women, supports informed decision-making, and strengthens the continuum of care from pregnancy through postpartum recovery. As such, birth preparedness is recognized as a cornerstone of safe motherhood initiatives and essential to achieving Sustainable Development Goal 3, which aims to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030 (WHO, 2015)⁵.

MATERIALS AND METHODS:

Materials:

Tool was Structured knowledge questionnaire with section A 5 items for assessment of demographic variables and section B containing 24 MCQ questions regarding fetal growth, fetal monitoring, warning signs of pregnancy -1^stand 2^nd trimester, signs of labour, stages of labor, pain management and hospital bag preparation. Level of knowledge is categorised as adequate (75-100%), moderate (50-70%) and inadequate (0- 45%). This tool was developed by researchers and validated by experts from the field of obstetrics and gynaecology department.

Methods:

Research approach and design:

The study was conducted as quantitative research approach with Quasi experimental – non equivalent pre-test post- test control group design.

Variables:

Independent Variable is Structured teaching program vs Self instructional module regarding child birth preparedness and the dependent variable is knowledge level of primigravida.

Setting of Study:

The study was conducted in outpatient and inpatient department of tertiary care hospital in Kottayam district.

Population:

The Population of the study was all primigravida, target Population was the primigravida women in the 2^ndand3^rd trimester of gestation and the accessible population was the primigravida women in inpatient and outpatient department of tertiary care hospital in Kottayam district.

Sample: The Sample Was the Primigravida Women in the 2^ndand 3^rd Trimesters and The Sample Size Was 30.

Sampling Technique:

Proportion in group I= 0.11, Proportion in group II = 0.46, Estimated risk difference = -0.35,

Power (1- beta) % = 80, Alpha error (%) = 5, 1 or 2 sided = 2 the required sample size was estimated to be 30.

Inclusion Criteria

· Primigravida who are in between 2^nd and 3^rd trimesters of gestation.

· Primigravida at an age group 18 to 40 years.

· Primigravida who are available at the time of data collection.

· Primigravida who are willing to participate in the study.

Exclusion Criteria:

Primigravida who are at first trimester.

Data Collection Procedure:

The pre-test was conducted for both experimental and control group after taking the institutional permission and institutional ethical committee approval. Level of knowledge was assessed by using structured knowledge questionnaire. Structured Teaching Program was given to experimental group and self-instructional module was given to control group. At the end investigators discussed and their doubts were clarified. Post test was taken after 7 days of the intervention for both experimental and control group.

RESULT AND DISCUSSION:

Table no1: Frequency distribution and percentage of study subjects according to their socio demographic variables (n=30)

S.i No	Sample characteristics	Frequency	Percentage
Age
1	18 – 22 years	1	3.33%
2	23 – 27 years	8	26.66%
3	28 – 32 years	17	56.66%
4	33 – 40 years	4	13.33%
Educational qualification
1	SSLC and Below	0	0%
2	Higher secondary	0	0%
3	Graduate	16	53.33%
4	Post graduate and above	14	46.66%
Occupation
1	Unemployed	10	33.33%
2	Health professional	8	26.66%
3	Government / private	12	40%
4	Business / self employment	0	0%
Previous education
1	Yes	10	33.33%
2	No	20	66.66%
Weeks of pregnancy
1	13 – 17 weeks	7	23.33%
2	18 – 22 weeks	6	20%
3	23 – 27 weeks	5	16.66%
4	28 – 32 weeks	12	40%

A majority of the participants, 17 (56.66%), were in the age group of 28–32 years. This was followed by 8 (26.66%) participants aged 23–27 years, 4 (13.33%) in the age group of 33–40 years, and 1 (3.33%) in the age group of 18–22 years.

In terms of educational qualifications, 16 (53.33%) of the mothers were graduates, while 14 (46.66%) had completed postgraduate education or higher. With regard to occupation, 12 (40%) were employed in government or private sectors, 10 (33.33%) were unemployed, and 8 (26.66%) were health professionals.

When assessed for prior education regarding childbirth preparedness, 10 (33.33%) mothers reported having received previous education, whereas 20 (66.66%) had no prior knowledge.

The distribution of mothers according to their gestational age revealed that 12 (40%) were in the 28–32 weeks group, 7 (23.33%) were in 13–17 weeks, 6 (20%) were in 18–22 weeks, and 5 (16.66%) were in 23–27 weeks of pregnancy.

Table no 2. Knowledge level of subject regarding child birth preparedness before and after Structured teaching program (STP)

(n=15)

Level of knowledge	Pre-test		Post test		t value
Level of knowledge	f (%)	Mean ± SD	f (%)	Mean ± SD	t value
Inadequate	3 (20%)	14.2± 3.60	1(6)	19.46± 3.71	3.95
Moderate	8 (53%)		2 (14%)
Adequate	4 (27%)		12 (80%)

The findings revealed that post-test of STP group 12% had adequate knowledge and one of them had inadequate knowledge where as in pre-test 20% had inadequate knowledge. The pre-test mean value was 14.2 with SD of 3.60and in the post test mean value was 19.46 with SD of 3.71. it showed that there was a high statistically significant difference in the level of knowledge with ‘t’ value of 3.95 at p< 0.05 level which in turn indicates that STP was effective in improving the knowledge regarding child birth preparedness among primigravida.

Table no 3. Knowledge level of subjects regarding child birth preparedness before and after Self Instructional Module (SIM). ( n=15)

Level of knowledge	Pretest		Post test		t value	p value
	f (%)	Mean± SD	f (%)	Mean ± SD
Inadequate	4(27%)	14.3± 3.45	4(26%)	14.4± 3.73	0.05	0.05
Moderate	9(60%)		8 (54%)
Adequate	2(13%)		3 (20%)

Table 4: Comparison of effectiveness of Structured teaching program (STP) and Self-instructional module (SIM) regarding child birth preparedness (n=30)

Domain	Mean	Standard deviation	t value	Unpaired t value	Df	P value
SIM	14.4	3.73	0.05	4.007	28	0.05
STP	19.46	3.71	3.95

The mean pre - test knowledge score of subjects were 14.3 where as the mean post - test knowledge score were 14.4 (t= 0.05). This shows that the calculated t value (0.05) which is less than the table value at p<0.05 significance. Thus self - instructional module was not effective in increasing the knowledge of primigravida mothers. (Table-3).

In the study, mean post-test knowledge score of STP group is 19.46 and t-value is 3.95was apparently higher than SIM group the mean post-test knowledge score 14.4and t-value is 0.05 respectively. Hence STP is more effective than SIM and the calculated unpaired T value of (4.007) which was found to be significant at p < 0.05 level which again confirms the efficiency of structured teaching programme (STP) than self instructional module (SIM). (Table-4).

CONCLUSION:

The study revealed that Structured teaching program (STP) was found to be more effective than Self instructional Module (SIM) in improving primigravida mother’s knowledge regarding birth preparedness.

ACKNOWLEDGEMENTS:

Here we extend our sincere thanks to all people who participated in the study.

CONFLICT OF INTEREST:

The author declares no conflict of interest in the study.

REFERENCES:

1. Chellaswamy M, Yadhav KP, Kalabarathi S. A study to assess the effectiveness of structure teaching programme on knowledge regarding birth preparedness and associated factors among primigravida mothers in SMCH Thandalam Chennai. Community Practitioner: The Journal of the Community Practitioners’ and Health Visitors’ Association. 2024 May 21(5):742-9

2. World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience. Geneva: World Health Organization; 2016.

3. JHPIEGO. Monitoring birth preparedness and complication readiness: tools and indicators for maternal and newborn health. Baltimore: JHPIEGO; 2004.

4. Muthulakshmi C, Yadhav KP. A study to assess the effectiveness of structured teaching programme on knowledge regarding birth preparedness among primigravida mothers at SMCH, Chennai. Int J Sci Res. 2024; 13(2):112–5.

5. World Health Organization. Trends in maternal mortality: 1990 to 2015. Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. Geneva: World Health Organization; 2015.

Received on 04.11.2025 Revised on 02.12.2025

Accepted on 26.12.2025 Published on 23.02.2026

Available online from February 28, 2026

Int. J. of Advances in Nursing Management. 2026;14(1):9-12.

DOI: 10.52711/2454-2652.2026.00002

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