Informed motherhood: Women’s knowledge of danger signs of obstetric complications and birth preparedness in low income communities in India

•The study is conducted in the slum communities of Pune city of India.•Women’s knowledge of danger signs of pregnancy complications and its association with birth preparedness.•There is strong association of knowledge of danger signs and birth preparedness. Objective of the study is to assess the knowledge about the danger signs of obstetric complications during pregnancy, childbirth and postpartum among women and its association with birth preparedness and complications readiness. A community-based cross-sectional study was conducted during January 2018 to February 2019 in the 10 urban slums of Pune. The slums were purposively selected for the study. Total of 500 women, who had given birth in the last two years, were recruited. Information about socio-demographic information, birth history, utilization of maternal care, knowledge about the danger signs of obstetric complications, and their birth preparedness collected. Descriptive statistics, bivariate analysis and logistic regression applied to examine the association. Results shows 93% of women had registered pregnancy; 67.4% had saved money for their delivery; 76% reported had made arrangements for transportation, and 84% decided on the place of delivery. Multivariate results showed that increasing educational level of women leads to increase in their birth preparedness (OR: 4.159; 95% CI: 1.794–9.644). Women with complete knowledge about obstetric complications during pregnancy are more likely to be bettered prepared for childbirth (OR: 4.235; 95% CI: 2.275–7.882); women having complete knowledge of pregnancy complication during childbirth (OR: 3.227; 95% CI: 1.953–5.332); and women with complete knowledge about post-natal complications also have higher chances of being bettered prepared (OR: 3.072; 95% CI: 1.944–4.855). Education level, knowledge about obstetric complications during pregnancy, childbirth and after delivery are important predictors for the birth preparedness of women from low-income communities in Maharashtra, India. Educating pregnant women about possible pregnancy complications could lead to birth preparedness.