Factors associated with birth preparedness and complication readiness practice among pregnant women in Lira city, Northern Uganda

Background Birth preparedness and complication readiness (BP/CR) is a key strategy for preventing adverse maternal outcomes. In Uganda, particularly in the northern region, little is known about women’s preparedness for childbirth and potential emergencies. This study assessed the level of BP/CR and its associated factors among pregnant women attending antenatal care (ANC) at Lira Regional Referral Hospital (LRRH), Lira City, northern Uganda. Methods A facility-based cross-sectional study was conducted among pregnant women attending antenatal care (ANC) at Lira Regional Referral Hospital (LRRH), Northern Uganda. A total of 291 participants were enrolled using a convenient sampling technique. Data were collected using a researcher-administered structured questionnaire assessing socio-demographic characteristics, individual practices, community factors, and components of birth preparedness and complication readiness. BP/CR was defined based on key preparatory actions, including identification of place of delivery, skilled birth attendant, emergency transport, financial savings, and potential blood donor. Data were entered and analyzed using SPSS version 26.0. Descriptive statistics were generated, and bivariate and multivariable logistic regression analyses were performed to identify factors independently associated with BP/CR at a 95% confidence level. Results Of the 291 women who were pregnant when we interviewed them, 208 (71.5%) were classified as well-prepared for childbirth and for complications related to that event. The two most common ways that these women said they were preparing for childbirth were by saving money for delivery (199/291 or 68.4%), and by knowing where to go in case there are problems during delivery (191/291 or 65.6%). The least common way that these women said they were preparing for childbirth was by having identified someone who could provide her with blood if she needed it (104/291 or 35.7%). Using logistic regression to adjust for other factors, being better-prepared for childbirth was associated with having a known place to go to obtain funds for delivery (adjusted OR = 4.04; 95% CI = 1.01–9.09), receiving help from a partner during pregnancy (adjusted OR = 2.12; 95% CI = 1.25–3.54), being knowledgeable about BP/CR (adjusted OR = 2.11; 95% CI = 1.04–6.29), and having knowledge of obstetric danger signs. Also, attending at least four prenatal care visits was associated with an increased likelihood of BP/CR. Conclusion Birth preparedness and complication readiness was relatively high among pregnant women attending ANC at LRRH; BP/CR was influenced by a combination of individual, household, and health-system-related factors. Strengthening targeted ANC counseling, promoting male partner involvement, and institutionalizing routine BP/CR assessment tools within antenatal clinics may further improve maternal preparedness and contribute to better pregnancy outcomes.