Birth Preparedness and Complication Readiness (BPCR) is an important strategy for reducing preventable maternal and neonatal deaths. Yet, having high antenatal care attendance does not automatically translate into adequate preparedness for childbirth and obstetric emergencies.

This review synthesized evidence from 14 publications and identified four interconnected domains of barriers: - Socio-cultural and gender-related barriers - Economic constraints - Health-system limitations - Knowledge and awareness gaps Viewed through the Three Delays Model, these challenges can contribute to delays in deciding to seek care, reaching health facilities, and receiving appropriate care once at a facility.

The review also highlights the need to move beyond simply promoting ANC attendance toward quality, structured BPCR counselling, stronger community and male engagement, improved financial protection, functional referral systems, and better health-system readiness.

Summary as published by the college when announcing this work. See the journal article for the full abstract.