JMJ Marist Brothers

NOTRE DAME OF MARBEL UNIVERSITY

Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

Introduction

Background of the Study

Improving birth outcomes, especially for socioeconomically disadvantaged

women, has long been a policy objective due to the potential severe social, personal,

medical, and financial repercussions of poor birth outcomes. According to the Philippine

Statistics Authority in mortality rate data of females in South Cotabato as of 2020 the

total deaths was 3, 836 with the percentage of 0.56. One of the common reason of

deaths was maternal morbidity. With the aim of improving pregnancy outcomes and the

health of the mother or child, antenatal care can be broadly defined as including

pregnancy-related services offered between conception and the start of labor. It also

includes giving women and their families/partners the right information and advice for a

healthy pregnancy, delivery, and postpartum recovery.

Prenatal care is a commonly practiced concept in the Philippines. Nearly

96% of moms had sought prenatal care from a medical professional (NSO and Macro

International, 2018). Pregnancy-related morbidity and death remain high despite

widespread access to prenatal care. There are still significant issues with newborn and

maternal mortality, with 162 women dying during childbirth for every 100,000 live births,

and 26 infants dying for every 1000 live births.Antenatal care (ANC) is a medical

procedure in which qualified staff members watch and care for a pregnant woman and

her unborn child in a medical institution. ANC includes all available types of care. From

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

screening to intensive treatment from the start of pregnancy through delivery are

provided to expectant mothers in the primary health care facilities (VillarJ.,et.al 2018). It

comprises risk assessment and management, control of illnesses brought on by or

occurring during pregnancy, health promotion, and education (Tunçalp Ö, et.al ,2018).

In short, the safety and wellbeing of women and their babies can be promoted through

antenatal care (ANC) (Benova et al., 2018).

Moreover, A prominent element of assessments in quality care is the measuring

of patient satisfaction. Clients' stated levels of satisfaction are a key sign of the caliber

of service since they represent experts' technical proficiency as determined by outside

evaluators. It is well recognized that a happy patient is more likely to follow the

instructions and recommendations given to her by medical specialists.Client satisfaction

was a result of patients' subjective reactions to care they received, as filtered through

their own preferences and expectations. Additionally, it is a measurement created to get

reviews or evaluations from clients regarding the assistance they received from a

business, hospital, or healthcare practitioner. Client satisfaction serves as a practical

substitute for the real measure.Although antenatal care (ANC) use is influenced by

client satisfaction, many maternal and perinatal fatalities occur in women who use ANC

infrequently. However, there has been significant progress done in terms of expanding

access internationally. Worldwide, just 70% of women ever receive any prenatal care,

compared to almost 95% of pregnant women in developed nations. Given adequate

quality of care and regular attendance, it has been anticipated that early and effective

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

implementation of ANC alone will reduce maternal and newborn mortality by 10%–20%.

According to a number of investigations, prenatal care (ANC) has little to no direct

impact on lowering MMR. New data, however, it suggest that ANC does contribute

significantly to reducing maternal and newborn mortality (Darmstadt GL, et.al 2019). As

reported to one study, in sub-Saharan African (SSA) nations, using ANC at least once

during pregnancy lowered the risk of newborn death by 39%. While maternal and

newborn death rates in the region are still high, the proportion of women who get

focused ANC for at least four visits is typically good around the world, including SSA

(Tekelab T.,et.al, 2019). A greater degree of care is given to those who require it while a

minimal standard of care is given to all expectant mothers and their newborn children in

maternal services.

Meanwhile, ANC is an useful preventative tool, recent strategic papers on

monitoring health services confirmed that there is still a problem with care quality that

need extra monitoring and assessment ( Pitrrof, et. al 2019). In order to reduce the risk

of maternal and perinatal death, international standards advise having regular medical

checkups throughout the prenatal period. It is advised that women start their ANC in the

right way throughout pregnancy in order to minimize difficulties, create more

opportunities for a healthier pregnancy, and optimize the advantages of monitoring both

the fetal and mother health. In keeping with the World Health Organization (WHO), ANC

should begin during the first trimester of pregnancy and should involve at least four and

ideally eight visits. The WHO specifically recommends that interactions begin within the

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

first 12 weeks of pregnancy, with following encounters occurring at weeks 20, 26, 30,

34, 36, 38, and 40 of pregnancy (Tekelab T.,et.al, 2019). However, it appeared that the

antenatal care (ANC) minimum level of suggested content was not being followed.

Studies evaluating the degree of compliance with the minimal amount of recommended

ANC content showed that most were unable to reach the national guidelines in both

developed and developing nations. Health education or other prescriptions had lower

compliance rates than physical examinations and routine laboratory testing (Victoria C.,

et.al 2018).

If ANC is of high quality and is regularly attended, maternal mortality can be

reduced by 20%. Attending ANC during pregnancy has a positive effect on the use of

postnatal healthcare services and is a crucial first step in persuading expectant mothers

of the advantages of having an attended delivery for their health. The degree to which

pregnant women are satisfied with the treatment they get at the medical institution,

however, may have an impact on how often they use ANC services.The level of patient

satisfaction may be used to judge the caliber of medical services and staff. It shows how

well the practitioner can attend to the demands of the patients. Individuals who are

happy are more likely to stick to treatment plans, continue utilizing healthcare services,

and preserve their connections with particular healthcare providers than patients who

are dissatisfied. Therefore, the aim of this study is to evaluate the satisfaction level on

the antenatal care among pregnant.

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

Review of Related Literature

This part contains the review of related literatures and studies about the

Satisfaction level on the Antenatal care provided among the pregnant women. It

explains the purposes and concepts of related study from the collected articles,

journals, recent studies and books.

Antenatal Care

Antenatal care is a medical service offered to a woman during her pregnancy in

modern obstetrics to make sure that pregnancy and childbirth won't have a negative

impact on her or her unborn child. Antenatal care was one of the four pillars of the Safe

Motherhood Initiative, emphasizing its significance. It aims to ensure that every newborn

child has a healthy start and to prevent health issues for both the mother and the child.

Care must be given in a suitable manner without going overboard. Continuous adoption

of new technologies is required, and existing services need to be reevaluated. Every

pregnant woman needs to get care that is specific to her needs and preferences.

Planning for the pregnancy and providing antenatal care continue throughout the early

neonatal and postpartum periods. In general, health professionals believe that a

pregnant woman's journey to receiving care begins with her first visit until the baby is

born, prenatal care is provided. Pregnant women and teenage girls get antenatal care

(ANC) from trained medical experts to provide the greatest possible health for both the

mother and the unborn child throughout pregnancy. It encourages healthy habits and

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

good parenting techniques while promoting a foundation for health promotion, risk

identification, prevention, and management of illnesses associated with pregnancy

(WHO, 2016).

Maternal mortality remained unacceptably high on a global scale. The greatest

cause of death among women between the ages of 15 and 29 was maternal mortality.

95 percent of all maternal fatalities took place in low- and lower-middle-income nations,

and the majority of them could have been avoided. Although some questioned its

applicability in the 1990s, readily available literature has proven that prenatal care

extends back to the 18th century and evolved in the 19th century. However, there is

broad consensus regarding the value of prenatal care in enhancing mother and

perinatal health. A number of conflicting reports have been made on how using prenatal

care services may result in institutional delivery, seeking advice for issues throughout

pregnancy, and seeking advice for complications following birth. The current prenatal

care model, which primarily addresses medical hazards, has to change in order to

encompass non-medical elements and encompass the entire community. Healthcare

practitioners need to be more aware of the social ills and domestic abuse that pregnant

women experience in their homes and communities. Services must be multidisciplinary

in order to treat both social and medical difficulties. Not only should clinics be equipped

to handle complex obstetrical concerns, but also social, mental, and addiction disorders

as well as chronic diseases including obesity, hypertension, diabetes, and infections.

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

Care must specifically reach women who would not otherwise use the services that are

offered (WHO, 2020).

Although there are disagreements over whether prenatal care visits should be

targeted or conventional throughout the world, the new antenatal care model has

become the norm in some developing nations. In light of this, the demographic and

health surveys conducted in developing nations focused on the importance of four

antenatal visits as one of the metrics for prenatal care quality in their report. There were

at least 4 prenatal care visits allowed in this analysis of the national data. Furthermore,

the best treatment has to start before to pregnancy because the early stages of

pregnancy have a significant influence on perinatal and eventual adult health.

Preconception health promotion has a positive impact on the health of future

generations in addition to improving the general health of women. Preconception care

may entail a mindset shift on the side of medical professionals as well as women, their

partners, and their families, but the advantages to society may again be substantial

(Temel S, et.al 2020).

Guidelines in Antenatal Care

According to World Health Organization of 2018 we need a program to improve

the gathering and use of a minimum set of ANC data to aid clinical decision-

making.ANC, maternal health, and perinatal quality management, improvement, and

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

surveillance out comes. Support initiatives to enhance the caliber of ANC services, such

as assisting teams and medical personnel to

Identify and remove major obstacles to local service delivery and the health system to

deliver evidence-based ANC services that are courteous, and to monitor a few ANC

quality-of-care process and outcome measures, to keep an eye on the standard and

women's experience with pregnancy care.

The frequency of obstetric hazard indications mentioned with women during ANC

counseling is positively and significantly correlated with the availability of facility-level

national ANC guidelines and in-service training for the ANC practitioners. In order to

create supportive conditions and guarantee that every ANC provider has access to

ongoing in-service training programs, decision-makers must prioritize money and policy.

Poor ANC quality is a result of insufficient resources, and many regular ANC

services appear to be underutilized. To provide excellent ANC services, however,

coverage of regular care alone is insufficient; instead, the significance of fundamental

evaluations and response-based treatments needs to be highlighted. The current ANC

quality metrics and recommendations do not offer enough direction for attaining high-

quality ANC that is tailored to the needs of each individual woman. To work toward a

realistic improvement in ANC quality, flexible quality assessment criteria that are

tailored to the local environment should be taken into consideration.

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

The WHO views appropriate clinical procedures as including by regularly

measuring blood pressure, routinely monitoring for hypertensive disorders, and for the

detection of fetal heart sounds, as well as advice on birth preparation and postpartum

family planning, where appropriatepractices.all interaction with pregnant women should

be polite, personalized, and person-centered care, with each contact delivering efficient,

integrated clinical practices (interventions and tests),delivers timely and pertinent

information, as well as psychosocial and emotional support from qualified professionals.

Working in a health system with effective clinical and interpersonal abilities.

Department of Health, Maternal Health Programs

The World Health Organization (WHO) mandates specialized prenatal care for all

expectant mothers. For the mother and the unborn child to receive the maximum benefit

of ANC, four visits are required: the first should take place between 8 and 12 weeks, the

second between 24 and 26 weeks, the third at 32 weeks, and the fourth between 36

and 38 weeks.The Nurse Deployment Program (NDP), run by the Human Resource for

Health (HRH) of the Philippine Department of Health (DOH), aims to send nurses to

underserved areas and Geographically Isolated and Disadvantaged Areas (GIDA)

across the country. The primary objective is to enhance the workforce in birthing homes,

barangay health stations, and rural health units. Under the Rural Health Midwives

Placement Program (RHMPP), midwives are also assigned to City Health Offices or

Rural Health Units in order to alleviate the unequal distribution of midwives and prepare

them for facility-based BEmONC practice.Under the Rural Health Midwives Placement

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

Program (RHMPP), midwives are also assigned to City Health Offices or Rural Health

Units in order to alleviate the unequal distribution of midwives and prepare them for

facility-based BEmONC practice. To complement existing RHU staff, the DOH's Rural

Health Team Placement Program (RHTPP) program places dentists, medical

technologists, and nutritionists/dietitians in field health facilities.Pregnancy-related

preventable morbidity and mortality were still at unacceptable levels in 2016 at the

beginning of the Sustainable Development Goals (SDG) era.3 Many mothers continue

to receive inadequate prenatal care.4 The fact that about half of deliveries were

performed at home lends support to this theory. Pregnant women, especially those in

rural areas, need encouragement and rewards to appreciate the need of prenatal

checkups and giving birth in medical facilities.

Maternal Care

Maternal care encompasses aspects of physical, mental, emotional, and social

health and refers to a woman's health and well-being before, during, and after

pregnancy. Maternal health/care also includes childbirth and the postpartum period, and

maternal health care services include antenatal care (ANC), delivery care, and postnatal

care (PNC). Maternal care has become a global concern because maternal health care

services can save the lives of millions of women of reproductive age. Despite efforts to

improve maternal health care services, maternal mortality remains high in the majority

of developing countries (WHO.Maternal health 2016).

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

The Philippine government offers free antenatal care (ANC), a crucial

preventative treatment that is required for all pregnant people. It is also referred to as

prenatal care, which is routine preventative healthcare offered to pregnant women that

enables doctors, nurses, and midwives to recognize, avoid, and treat any health issues

throughout the course of the pregnancy. Additionally, it encourages healthy lives for

both mother and child.Maternal care is one of the country's six priority areas in its

reproductive health strategy. Several factors have been discovered to be associated

with the utilization of maternal health care services. In general, the associated factors

are socioeconomic and demographic in nature, such as the mother's educational status,

maternal age, occupation, mothers' knowledge of danger signs, marital status, women's

autonomy, birth order, religion, sex of household head, household income, household

size, husband's educational status, accessibility factors, and factors related to women's

perceived quality of maternal health care services.

In relation to maternal care, women's health during pregnancy and delivery is

critical for both the mother and her children. Each stage should be a positive experience

that ensures women and their babies reach their full health and well-being potential.

Despite significant progress over the last two decades, approximately 295 000 women

died during and after pregnancy and childbirth in 2017. This figure is far too high as

reported by WHO. Poor maternal health-seeking behavior stymies efforts to improve

women's health. Finding the cause of this behavior is important in order to design

interventions for better utilization. Because maternal health care is a complex

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

phenomenon that can be influenced by geo-cultural settings, a thorough contextual

investigation is required as explained by (Yared M, Asnakech M., 2017) Furthermore,

the findings of various studies on the relationship between maternal health care are

inconsistent.

To sum it off, maternal care aims to maintain and expand access to care by

developing, strengthening, and better defining relationships among facilities in a region.

Each facility should have a clear understanding of its capacity to handle increasingly

complex levels of maternal care, as well as a well-defined threshold for transferring

women to higher-level care facilities. If additional travel to a more distant level-

appropriate hospital increases risk, the nearest level-appropriate hospital should be

used in an emergency.Maternal health care services requires that there be available

and coordinated specialized services, professional continuing education to maintain

competency, facilitation of opportunities for transport and back-transport, and collection

of data on perinatal outcomes to evaluate the effectiveness of delivery of perinatal

health care services and the safety and efficacy of new therapies. Because the health

statuses of women and fetuses may differ in acuity, referral should be organized to

meet the greatest needs of either or both as explained by (American Journal of

Obstetrics and Gynecology, 2019).’

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

Leopold Maneuvers

The Leopold maneuvers, named after the German obstetrician and gynecologist

Christian Gerhard Leopold, are used during the physical examination of pregnant

women (1846-1911). The four Leopold procedures that can be used to estimate the

baby's size and position in the uterus are the fundal grasp, umbilical grip, Pawliks grip,

and pelvic grip (Scully, S., 2022). These procedures are performed by qualified medical

personnel. These are also used to palpate the uterus methodically during pregnancy.

This abdominal palpation technique is cheap and easy to use. Furthermore, it is used to

determine the engagement, presentation, and position of the fetus during pregnancy.

According to the current research, applying Leopold's Maneuvers abdominal

palpation during nursing interventions can enhance maternal awareness of fetal

positioning, maternal-fetal bonding, and frequency of the mother-fetus communication.

There are also a few studies that compare clinical evaluation with ultrasonography, the

gold standard for detecting non-cephalic presentation in the third trimester of

pregnancy. These researchers discovered that a sizable portion of misrepresenting

fetuses are missed by abdominal palpation. When it came to multiparous women and

those with lower body mass indices, clinical examinations were relatively sensitive. As

gestational age and body mass index declined, the clinical examination's specificity rose

noticeably. Due to the low prevalence of malpresentation in low-risk individuals, it was

discovered that false-positive diagnoses were a more common error when abdominal

palpation was tested as a screening tool for diagnosing malpresentation. Obese

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

pregnant women and pregnancies complicated by polyhydramnios, fibroids, or anterior

placental location have been reported to find Leopold maneuvers difficult. In clinical

practice, using a second examiner, pelvic examination, and rescheduling a return visit

with a sequential abdominal examination can help to improve the accuracy of abdominal

palpation findings (Superville, S. S., &Siccardi, M. A., 2022).

The primary objective of Leopold Maneuvers was to assist and support Leopold's

four inspection techniques for determining the location of the fetus within the pelvic

cavity. The landmarks required for this examination are present in the fetal baby used

as a simulator. This category includes the head, shoulders, spine, elbows, knees, and

feet. Leopold maneuvers can assist mothers in perceiving and visualizing their fetuses.

Abdominal palpations can thus help to develop the maternal-fetal relationship, which is

important for a child's psychological, cognitive, and social development.

Theoretical Framework

A change in ANC visits from a minimum of four to at least eight visits has been

advised by World Health Organization (WHO) recommendations in order to reduce

perinatal morbidity and death and improve women's experiences with treatment (Unicef,

2021.) Services for antenatal care (ANC) are crucial for pregnant women's and unborn

children's health (WHO, 2018). To realize the full potential of the ANC services,

however, prompt booking is a crucial first step in the early detection and prevention of

pre-existing medical issues and pregnancy-related difficulties (WHO, 2018). The degree

of self-determination affects a pregnant woman's capacity to make an informed choice

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

and implement sensible activities regarding timely use of ANC treatments.In countries

such African Countries, women have the option to decide for themselves on topics

impacting their social and health. Pregnant women may have delayed ANC scheduling

due to a lack of autonomy and decision-making authority, which may put them at risk for

avoidable maternal morbidity and death. Evidence from first-world nations suggests that

self-determination among postnatal women includes the use of reproductive health

services, particularly prompt ANC scheduling, to their health's advantage.The use of

theories and models aids in understanding the factors that influence certain behaviors

connected to one's health. (Alemayehu, 2018).

Self- Determination Theory

The idea that there are many obstacles will probably cause people to believe that

these obstacles exceed the advantages of prenatal care, which may result in poor

utilization. To increase usage of these services, it is crucial to comprehend the mothers'

perceptions of the advantages of and obstacles to prenatal care (Parsa et.al 2018).

According to the self-determination hypothesis, when people's demands for

competence, relatedness, and autonomy are met, they can become self-determined.

Acting with a sense of freedom and having a sense of self or choice is referred to as

perceived autonomy. On the other side, perceived competence indicates a person's

confidence in their ability to bring about the intended results. The drive to develop and

maintain a relationship in a social setting, such as among family members, is reflected

in one's perception of their relatedness (Cherry, 2019). Adopting the self-determination

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

theory makes it easier to comprehend how mother self-determination influences

decisions about desirable behaviors, such using prenatal care facilities. Using this

theory enables researchers to evaluate a person's perceived competence, relatedness,

and autonomy levels, which combined indicate how self-determined they are to take the

right action (Ryan, et.al.,2017).

Health Belief Model

One of the most popular theoretical frameworks for comprehending and

forecasting health behaviors is the Health Belief Model (HBM). According to the HBM,

an individual's behavior is driven by two things: 1) a desire to avoid or recover from a

medical condition for which they perceive they are at risk, and 2) the conviction that a

certain course of action would avert or lessen the problem. Whether a person adopts a

healthy behavior depends on their assessment of whether the advantages outweigh the

obstacles to doing what is required, provided that these obstacles are not very strong.

(Glanz, 2016). The health belief model proposes that individual perception and health

beliefs are important in engaging in desired behaviors, in this case, the timely and

appropriate use of adequate antenatal care services. These behaviors are influenced by

an individual's perceptions of susceptibility, severity, benefits, barriers, and exposure to

cues-to-action.

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

Ajzen’s Theory of Planned Behavior

Ajzen’s Theory of Planned Behavior will be used to guide this study, when a

behavior is positively evaluated, believed to be within one's own control, and supported

by influential individuals, a person will have the intention to engage in it. How a person

assesses birth readiness affects their intention to prepare for childbirth. If people view it

favorably, think it is significant, believe it is beneficial, and believe they can execute it,

they will be motivated to get prepared (Moshi, F. V., Kibusi, S. M., & Fabian, F.

2018).This well-supported and extremely practical theory has gotten a lot of attention

from publications, presentations, and consultations all around the world.The standard of

nursing practice in all clinical and community settings has been raised owing to Ajzen's

Theory of Planned Behavior, which has also given nursing science the direction it needs

to advance. His contributions to nursing science and leadership have enhanced the

service of all clinical and community setting.

Self-Care Deficit Theory

Another theory that supports the study is Dorothea Orem's Self-Care Deficit

Theory.According to this approach, Self-Care Deficit involves two (2) actions in Orem's

theory and these are to organize the elements of the patient's therapeutic self-care

requests and to choose a combination of ways to assist that will be successful and

efficient in forming for the patient's deficit in self-care (TK, A., & Chandran, S. 2017).

This theory suggests that people should be self-reliant and accountable for their own

care in order to recover faster. It also provides guidance for practitioners in ambulatory

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

surgery settings, where nurses assist clients by supporting, and providing a

developmental environment. Self-care lowers stress, restores a nurse's capacity for

empathy and compassion, and enhances the standard of care. Self-care can also help

pregnant women feel better about themselves. It can also help to relax their tension,

which will undoubtedly have a beneficial effect on how pregnant women view

themselves.

Conceptual Framework

Independent Dependent

Antenatal Care Level of Satisfaction of

Check-ups Pregnant Women

Physical Examinations

Fetal Monitoring

Health Promotion

Figure 1. Conceptual Framework

The presentation above shows the guide of relationship between the variables. It

outlines the research process important objectives to fit together to provide meaningful

findings. It will also serve as the basis for conceiving the literature review.

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

STATEMENT OF THE PROBLEM

This study aim to know the Level of satisfaction on the Antenatal Care among

pregnant women.Specifically it will answer the following:

1. What is the demographic profile of the pregnant women, in terms of:

Age:

Parity:

Gestation Age:

2. What is the level of satisfaction on the antenatal care program among pregnant

women within 13 – 37 weeks of gestation, in terms of physical examination, fetal

monitoring and screening, and health promotion.

Significance of the Study

This research will provide evidence-based information regarding how well home

visits assist pregnant women in adhering to their antenatal checkup schedules. The

outcomes of this study will be incredibly useful and relevant, particularly in the following

areas:

The Pregnant Women. The results of this study will undoubtedly be helpful to

the respondents since they will have the necessary information to help them cope with

the stress they will be feeling. Additionally, this will allay their delivery-related worries.

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

Furthermore, it enables the implementation of prenatal abnormality screening and other

preventative measures.

The Nurses. This would ensure that all gathered data will serve as a guide to all

nurses regarding maternity care and potentially reducing disparities in pregnancy

outcomes. The preventative and strategy approach that would go along with this study

will be beneficial to both the researcher and the nurses that will assist them in deciding

what kind of assistance and service to offer. The acquire knowledge they could get in

this study will hone their abilities to execute a precise home visits for antenatal care,

including the specific information they can offer to guarantee the mother and baby are

healthy during gestation.

The Institution and Communities. It may use the results of this study to learn

more about the advantages of prenatal care and how to develop strategies to advance

mother and child health. It will help every facility and other communities identify any

potential issues that would increase the risk of complications during pregnancy and

delivery. The study's findings will undoubtedly aid the institution to be prepared as well

as forge important connections within each institution and community in order to

encourage additional research participation and involvement in this area.

The Nursing Department. The study will act as a valuable source of information

for the department. They can use this tool to find out more about how well home visits

help expectant moms keep up with antenatal checkups. They will be able to tell if it will

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

support moms in their decisions regarding their pregnancies, labors, and deliveries as

well as foster confidence in parenting abilities.

Department of Health. The outcomes of this study will provide an opportunity for

the Department of Health to answer patients' queries to address their concerns about

the service they receive in order to enhance patient care. With the help of this research,

they will be able to identify and treat certain conditions before they cause harm to both

the mother and child. Furthermore, it allows them to visualize their future plans and

prepare accordingly in order to be better equipped to assist our expectant mothers with

antenatal care.

The Student Nurse. Serve as a guide in order to decide whether home visits to

encourage pregnant women to keep up with antenatal checkups are successful in

reducing maternal morbidity and mortality. To sum up, it will help to determine the best

ways to promote health, as well as the possible risk factors, preparation for childbirth,

and where to go for care if pregnant issues arise. Additionally, it served as a resource

for the student nurse to learn about the types of management that needed to be

improved to assure the mother's condition.

Future Researchers. The results of this study will have a substantial impact on

each of the researchers' analytical skills, which will definitely challenge their approaches

and increase their comprehension as to how home visits affect the antenatal care.

Additionally, this investigation will help the researcher to detect any potential issues,

potential complications, and sentiments that our pregnant women have when receiving
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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

antenatal care. The results of this study will unquestionably have a substantial impact

on their capacity to assess information and participate in constructive debate about this

subject. This would aid in initiating action, gathering evidence for ideas, and contributing

to the advancement of knowledge on a specific topic. This will also give the future

researchers a hint as to what kind of risk the mother might be exposed to and an

understanding of the needs and priorities of women in the local area. Furthermore, this

study will allow them to access a diverse group of women with experience of home visit

Scopes and Limitations

The aim of this study is to assess the level of satisfaction on antenatal care

among pregnant women. The study will be conducted in the first semester of the

school year 2022-2023. Data will be collected by face-to-face survey using a

structured survey questionnaire to obtain the data related to the research objectives

specifically to pregnant women who are in 2 to 3 trimester that will represent as the
nd rd

participants of the study. However, the study will be limited only to pregnant women at

the City Health Office, Koronadal City, South Cotabato. The analysis of data will be

based on the participant’s answers to the survey questionnaires. The findings of the

study are exclusively only for pregnant women which represent the participants of the

study and cannot be generalized to all females.

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

Definition of Terms

Antenatal Care – care receives the pregnant mother during and after deliveries.

It includes physical examination, fetal monitoring and screening.

Demographic Profile – information gathered among pregnant women, it

includes age, parity and age gestation.

Gestation – It refers how far along the pregnancy is, and measured by weeks. It

can be calculated from the first day of the last menstruation of

Leopold’s Manuever – A method to identify the fetus location, presentation and

engagement in pregnancy through abdominal palpations.

Level of Satisfaction – The pregnant perception on quality and goodness on

antenatal care. It is the study aims to know among pregnant women on antenatal cares.

Maternal health and care - It encompasses the health dimensions of the

pregnant woman during and after delivery. This concept ensures that pregnant women

and their newborns achieve their full health and well-being potential.

Pregnancy - It takes place after an egg is released from the ovary during

ovulation when a sperm fertilizes it. It typically lasts 40 weeks or more, from the last

menstrual cycle to delivery.

Maternal Morbidity - It describes any immediate or long-term health issues

brought on by pregnancy and childbirth.

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

Maternal Mortality - Is the term used to describe the death of a woman due to

pregnancy-related or childbirth-related issues that take place either during the

pregnancy or within six weeks after it ends.

METHODOLOGY

This study will focus on the satisfaction level of antenatal care among pregnant

women. In this study, the researchers will use quantitative descriptive type of research

to obtain the data of the selected participants. This part contains the research design,

locale of the study, research participants, research instrument, data gathering and data

analysis.

Research Design

This research will use a Quantitative Descriptive approach as research design.

The researcher will be utilizing survey questionnaire among the pregnant women who

have experienced antenatal care. According to Williams C. (2018), In order to obtain

findings, a quantitative research technique deals with quantifying and analyzing

variables. Descriptive approach mainly concerned in explaining the circumstance or

case that is the subject of the investigations. This research design will evaluate the

satisfaction level of the pregnant women on the antenatal care provided for them. Thus,

this method will aim to measure the data by using frequencies, percentage and

weighted mean as the result of their responses on the given structured survey

questionnaires.

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

Level of Satisfaction on the Antenatal Care among

Pregnant Women

STATEMENT OF THE
PROBLEM Locale of the study

City of Koronadal, South Cotabato

What is the
demographic profile
of the pregnant
women in terms of Participants

AGE: Pregnant Women (2nd to 3rd Trimester)

PARITY:

Research Instrument
GESTATION AGE:

cvlever of
What is the Survey Questionnaire
Satisfaction on the
antenatal care
program among Data analysis
pregnant women
within 13-37 weeks of Frequency, Percentage, Weighted mean
gestation

In terms of Physical examination,

fetal monitoring, screening and
health promotions.

Figure 2. Nursing Paradigm

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

Locale of the Study

The study will be conducted at the government-owned Koronadal City Health

Office, which is located at Andres Bonifacio Street, Poblacion, Koronadal City, South

Cotabato. Andres Bonifacio Street has a length of 0.76 kilometers, a Latitude of 6° 29

'46.32 `` and Longitude of 124°50'17.16". Koronadal City Health Office is dedicated to

offer high-quality, convenient healthcare services to the residents of Koronadal City and

nearby towns.

With the assistance of the City Health Office, the researcher will choose a

respondent and gather data from an expectant woman living in Koronadal City, South

Cotabato to give them the information they need for the study and to determine how

satisfied pregnant women are with their antenatal care.

Figure 3. Map of City Health Office, Koronadal City

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

Participants of the Study

The participants of the study are pregnant women residing at Koronadal City,

South Cotabato. In this study, the respondents are selected based on the set of criteria

and characteristics which are (1) The participants must be a pregnant women (2) The

gestation age must be 13 weeks to 37 weeks (2 trimester to 3 trimester) and (3) The
nd rd

participants are willing to participate in the study. The researchers will use non-

probability sampling. This method is called purposive sampling. The participants are

handpicked based on certain qualities and characteristics for the purposes of the study.

The main goal of the sampling is to identify the satisfaction level of the pregnant women

on the antenatal care provided. According to Bernard (2019), Instead of choosing study

participants at random, intentionally sampling entails an ongoing selection procedure. It

is a nonrandom approach; therefore, no underlying hypotheses or predetermined

number of informants are required. Simply defined, the researcher chooses what

information is necessary to have and then searches for sources willing and able to

supply it based on their expertise or experience. The researcher gains skills in selecting

informants effectively and intelligently, as well as selecting the amount of analysis

required to achieve certain aims, via repeated use of technique.

Research Instrument

The researchers will utilize survey questionnaires which will be answered by

pregnant women with 2 to 3 trimester of pregnancy who underwent antenatal care

nd rd

27
 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

check-ups at the City Health office of Koronadal City. Close-ended questions will be

used to identify the level of satisfaction of pregnant women. The survey questionnaire

will include the contents of the statement of the problem. For the SOP 1, the participants

will indicate their demographic profile by answering the indicated questions, SOP 2 will

be the level of satisfaction of the pregnant women on antenatal care.

Data Gathering

The researchers will send a letter to the RHU midwife in 2022 that contains a

consent form, and make a request for an authorization letter to collect data from

pregnant women during the time of prenatal day at the office. Before the researchers

will give the survey questionnaires to the participants, they will be required to sign a

consent that they understand the study including the objectives and purposes to

participate in collecting data. The informed consent will be given face to face, by

agreeing to the objectives, the survey questionnaire will be given. The researchers will

save the information on Google Forms in a Google drive account accessible only to the

researchers. The data provided on Google drive thereafter subjects for processing.

Data Analysis

The statistical data was based on the respondent’s answers to the

questionnaire. The data will be presented through figures and tables. The response will

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

be tabulated and computed to describe the Level of Satisfaction on Antenatal Care

among Pregnant Women. Mean average, frequency and percentage were used to

classify the demographic profile of the respondents and the results to which extent the

Level of Satisfaction on the Antenatal Care among Pregnant Women. Descriptive

statistics is used to describe the basic features of the data in the study in which

researchers will be providing summaries about the sample and measures. Weighted

mean, Frequency, and percentage were both the medium in describing the extent of

which Level of Satisfaction on the Antenatal Care among Pregnant Women. The

researcher utilized the Privacy and Confidentiality protocol to guarantee data privacy.

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 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

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NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

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NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

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Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

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NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

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NOTRE DAME OF MARBEL UNIVERSITY
Alunan Avenue, Koronadal City
College of Arts and Sciences
NURSING DEPARTMENT

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