CHAPTER ONE
INTRODUCTION
1.1 Background of the Study Infection during pregnancy is an important, potentially preventable, and yet often overlooked cause of maternal, fetal and neonatal mortality and morbidity. Studies have shown mother’s health behavior, to have direct effect on the woman’s health and that of her baby (Dean with Kendall, 2014). Pregnancy is arbitrary divided into three trimesters. The first trimester carries the highest risk of miscarriage, and harm due to teratogens or infections leading to varying degrees of complications and anomalies (Medicine Net, 2011). Women during pregnancy are often obligated to meet their daily routines or activities, make contact with items or persons that include family members, relatives, friends and others either directly or indirectly, which exposes them to potentially hazardous pathogens that may lead to infection (Dean with Kendall, 2014). The hormonal changes that occur during pregnancy further increase the risk for both pregnancy and non-pregnancy related infections due to the physiological immune-suppression associated with the action of human chorionic gonadotropin and prolactin (Fraser, Cooper with Nolte, 2008). While this hormonal change is necessary for the survival of the fetus, it causes a physiological immunosuppression, which increases the risk of infection during pregnancy (Tarmasi, Horrath, with Bohacs, 2011). Puerperal infection defined by the World Health Organization (WHO) as the infection of the genital tract occurring anytime between the rupture of membrane or labour and the 42nd day postpartum, is the second leading cause of maternal death. It accounts for 10-14% of maternal deaths globally and 17% in Nigeria (Adesokan, 2011). This impact according to Gravett, Gravett, Martin, Bernson, Khan, Boyles, et al (2012) includes pregnancy and non-pregnancy related infection occurring during pregnancy, than attributed to puerperal sepsis alone. In the International Health Community, is the growing recognition that most successful interventions depend on behaviour change, in line with infection prevention intervention strategy. Virtually all maternal and child health activities targeting infection prevention during pregnancy as cited by Halpin, Martin-Moreno and Maria (2010), requires a form of behaviour change, failure of which may lead to varying degrees of pregnancy and birth related complications. Infection prevention in pregnancy requires preventive health behaviours, which is the action healthy expectant mothers undertake to keep themselves or others healthy and prevent infection or detect an illness when there are no symptoms (Labspace, 2013). While the aim is relatively simple, which is to ensure a healthy and alive mother and child, the circumstances in which they operate such as gravidity, parity, educational level, occupation, socio-economic status and so on. Often influence and necessitate their being complex and multidimensional. The relationship between pregnancy outcome and bad health behaviours, most of which show that, negative health behaviours predispose to infection, pregnancy and labour complications such as: miscarriage, preterm labour, congenital anomalies/infections of the newborn, maternal and fetal death (Kidspot, 2013). But in spite of the evidence of complications associated with infection during pregnancy, and the numerous health information along with nutrition concerns, food-safety, health promotion, exercise and illness prevention that expectant mothers receive, a review by Azuogu, Azuogu, and Nwonwu (2011) reveals that the health behaviour of Nigeria women regarding pregnancy related care remains poor and poses one of the greatest challenges to maternal and child health. The participants reported a significant education in their level of physical activity during pregnancy, a significant increase in consumption of fruits, vegetables, and fibres and a decrease in fast food consumption (all P<0.05). Medical practitioners are the preferred source of health information but seem to provide insufficient information about health behaviours during pregnancy in relation to physical activity, diet and weight management. They recommended a need to improve the provision of health information on physical activity, diet and weight management in the antenatal period. Kost, Landry and Darroch (2018) conducted a study to predict maternal behaviours in relation to intenseness, independent of social and demographic characteristic in the United State using a multivariate analysis of data from the National Maternal and Infant Health survey and the National survey of family growth. The findings showed that women with intended conceptions are more likely than similar women with unintended pregnancies to recognize early signs of pregnancy and to seek for early prenatal care, and somewhat more likely to quit smoking. But they are not more likely than women with comparable social and demographic characteristics to adhere to a recommended schedule of prenatal visits once they begin care, to reduce alcohol intake, or to follow their clinician