What is Birth Preparedness and Complication Readiness (BPCR)?
BPCR is a comprehensive strategy developed to address the three-delay model, which contributes to high maternal and neonatal mortality rates in low-resource settings. These delays include delays in seeking care, reaching a health facility, and receiving adequate care upon arrival. By promoting proactive planning during pregnancy, BPCR aims to empower families to overcome these obstacles and ensure timely access to skilled care. The program emphasizes a matrix of shared responsibilities, involving the pregnant woman, her family, the community, and health systems. The specific components of a BPCR plan can vary slightly depending on regional context, but they generally encompass several key areas of readiness.
Key Components of a BPCR Plan
Preparing for both a normal birth and potential emergencies is at the heart of the BPCR strategy. A woman is often considered 'well-prepared' if she has made arrangements for a specified number of these core components, as assessed in various public health studies. The following are the most commonly identified components:
- Identifying a Place of Delivery: Planning where the birth will take place, ideally a health facility with a skilled birth attendant, is a foundational step. This minimizes the risk of complications during an unsupervised home birth.
- Identifying a Skilled Birth Attendant: Ensuring a trained professional will be present at the birth is crucial for safe delivery and for managing potential complications. This can be a midwife, a nurse, or a doctor.
- Saving Money: Financial resources can be a significant barrier to accessing timely care. Setting aside funds for birth-related costs, supplies, and potential emergency obstetric complications is a critical component. This practice addresses financial delays in seeking or receiving care.
- Arranging Emergency Transportation: Pre-planning for how to get to a health facility quickly during labor or in the event of an emergency is vital. This is particularly important for women living in rural or hard-to-reach areas.
- Identifying a Labor and Birth Companion: Having a trusted support person accompany the woman to the health facility can provide emotional support and assist with decision-making.
- Identifying a Caregiver for Other Children: If the pregnant woman has other children, arranging for their care while she is away for delivery is an important part of the plan.
- Awareness of Obstetric Danger Signs: Knowing the key warning signs of pregnancy and childbirth complications empowers the woman and her family to recognize problems early and seek immediate medical help.
- Arranging for a Blood Donor: Identifying a compatible blood donor in advance can be life-saving in cases of severe hemorrhage during or after childbirth.
The Role of Technology and Education in Improving BPCR
Beyond basic planning, modern interventions often incorporate education and communication to enhance BPCR practices. Technology, particularly mobile health initiatives, can be leveraged to disseminate BPCR information and reminders to pregnant women and their families. Providing clear, accessible information on BPCR components and potential danger signs can significantly improve readiness and outcomes. Health professionals and community health workers play a vital role in educating women during antenatal care visits, using questionnaires and counseling to ensure all components are addressed.
Comparison: Birth Preparedness vs. Complication Readiness
While BPCR is often considered a single concept, it is helpful to distinguish between its two primary aspects:
| Aspect | Focus | Example Actions | Primary Goal |
|---|---|---|---|
| Birth Preparedness | Planning for a normal, expected birth. | Identifying a place of delivery, saving money for routine costs, gathering essential delivery items, choosing a skilled birth attendant. | Ensure a safe and planned delivery under skilled supervision. |
| Complication Readiness | Planning for potential emergency complications. | Arranging emergency transport, identifying a nearby emergency health facility, arranging for a blood donor, knowing key danger signs. | Reduce delays and increase survival in the event of an obstetric emergency. |
This distinction highlights that being ready for an emergency is a separate but equally important part of the overall strategy. Even if a birth is planned to be routine, a complication can arise at any time, and having a readiness plan can make all the difference.
Conclusion
In the context of maternal health, the components of BPCR are a structured set of actions aimed at proactively planning for a safe birth and anticipating potential complications. This strategy moves beyond simply seeking antenatal care to actively preparing for delivery by securing financial resources, transport, a skilled attendant, and support systems. The success of BPCR interventions, particularly in low-resource settings, has been associated with significant reductions in maternal and neonatal mortality by directly addressing critical delays in accessing care. Therefore, understanding and implementing these components is a crucial step towards improving maternal and neonatal health outcomes globally. For more information on the efficacy of these programs, studies like the meta-analysis published in BMC Pregnancy and Childbirth provide compelling evidence for their positive impact.
