Does antenatal care influence postpartum health behaviour? Evidence from a community based crosssectional study in rural Tamil Nadu, South India

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Abstract
To study the association between attendance to antenatal care and postpartum health behaviour among women in rural Tamil Nadu, South India. Community based, cross-sectional questionnaire study of 30 randomly selected areas served by health subcentres. Rural parts of Salem District, Tamil Nadu, South India. 1321 women who were delivered in the six months before the questionnaire-based interview. Feeding of colostrum, time of initiation of breastfeeding and maternal dietary habits during the first month postpartum. The median number of antenatal visits was four (range 0-51; lower quartile 3, upper quartile 7)., The fifth month of pregnancy was the median time for the initiation of antenatal care. Pregnant women 1. who had a large number of antenatal care visits, 2. who initiated antenatal care in the first trimester or 3. who reported having received information about breastfeeding were more likely to feed colostrum (odds ratio 1.48; 95% CI 1.06 to 2.07), (odds ratio 1.40; 95% CI 1.06 to 1.85), (odds ratio 1.66; 95% CI 1.29 to 2.14, respectively). Only women who reported having received information about breastfeeding were more likely to initiate early breastfeeding (odds ratio 1.81; 95% CI 1.34 to 2.43). Use of antenatal care facilities was not associated with maternal postpartum dietary habits. A large number of women attended antenatal care in the study area, but antenatal care had a limited effect on postpartum health behaviour. As antenatal care is considered an essential part of primary health care and takes up considerable resources, we recommend further research to explain the gap between the intentions of antenatal care and the actual outcome of such care.