Original Research Article The Journal of Community Health Management, January-March 2016;3(1):5-10 5 ‘Bleeding Mothers’ A Sequel to Underutilization of ANC Package – A Community Based Cross Sectional Study from Central India Akash Ranjan Singh 1,* , Ashok Madhukarrao Mehendale 2 , Pradeep Ramrao Deshmukh 3 Abhishek V Raut 4 , Arun Mahadeo Kokane 5 1 Senior Resident, 5 Additional Professor, Dept. of Community and Family Medicine, All India Institute of Medical Sciences, Saket Nagar, Bhopal 2 Professor & Head, 3 Professor, 4 Associate Professor Dept. of Community Medicine, Mahatma Gandhi Institute of Medical Sciences Sevagram, Maharashtra, India *Corresponding Author E-mail: akash.srcfm14@aiimsbhopal.edu.in Abstract Background: Despite the large numbers of women who are estimated to have suffered maternal hemorrhage, little is known about their health effects, psychological, social and economic consequences. This study was carried to find out the magnitude and epidemiological determinants of Maternal hemorrhage through a community based cross sectional study. Method: This cross sectional study was conducted in field area of a Primary Health Center of Central India. The study subjects were mothers who delivered a live baby or still birth, within the past one year from the date of interview. Thirty clusters of individuals recruited through cluster sampling method. From every cluster 12 subjects were selected using random walk method giving a total sample size of 360. Data collection was done by using pre-tested and pre-designed questionnaire. ANC card and/or any medical record if available were used to retrieve the relevant data. The data was entered and analysed by using Epi_info (Version 6.04d) software package. Results: The prevalence of maternal hemorrhage was found 15% among study subjects. Out of those who suffered Maternal hemorrhage 30% suffered from Antepartum and 70% from postpartum hemorrhage. Maternal hemorrhage was significantly associated with ANC package utilization however, it was not found to be associated with age, caste, parity and birth order of mothers. Conclusion: Maternal hemorrhage is significantly associated with the ANC services utilization. ANC services, in spite of being easily accessible to the mothers, are poorly utilized and this might be an important determinant of maternal hemorrhage and subsequently ‘continuum of care’. Key words: ANC package, Cluster sampling, Maternal hemorrhage Access this article online Quick Response Code: Website: www.innovativepublication.com DOI: 10.5958/2394-2770.2016.00015.6 Introduction Maternal Morbidity has a potentially critical role to play in the successful outcome of pregnancy in terms of maternal and infant survival and wellbeing. 1 Universal access to reproductive health was a target of Millennium Development Goal (MDG) 5B and along with MDG 5A to reduce maternal mortality by three- quarters. Progress is currently too slow for most countries to achieve these targets by 2015. 2 In developing countries, maternal hemorrhage continues to be a leading cause accounting for 25-43% of maternal deaths. 3,4 A systematic review has estimated the global prevalence of PPH to be from 2.8% to 10.8% depending upon the severity, and study setting. 5 While there are no national data on the magnitude of Maternal hemorrhage in India but based on the global estimate, it may be inferred to be very high. 6-9 It was observed that there was considerable inter study variation in the levels of Maternal hemorrhage in these studies. These studies were based upon self-reported histories as well as clinical examination. In a few studies laboratory investigation was also done. Despite the large numbers of women who are estimated to have suffered Maternal hemorrhage, little is known about their health effects, psychological, social and economic consequences. 10 In absence of well-designed community-based studies, it is rather difficult to know the true extent of Maternal hemorrhage in the community. Community based prevalence data gives a robust picture of the magnitude of any disease which is essential for setting priorities for planning and resource allocation in the national programme. Considering the need for such information, the present study was undertaken to assess the magnitude and determinants of Maternal hemorrhage in Kharangna (Gode) Primary Health Center of Wardha district of Maharashtra State to find out magnitude and epidemiological determinants