Background: Avoidable mortality and morbidity remains a formidable challenge in many developing countries like Ethiopia. Pregnancy related complications can not be reliably predicted and it is necessary to design strategies to overcome those problems when they arise. Objective: To assess knowledge and practices with respect to birth preparedness and complication readiness and factors associated with their practices among women who gave birth in the last 12 months preceding the survey in Adigrat Town, Tigray Regional State, Ethiopia. Method: A cross-sectional community-based study was conducted in September and October 2006. A total of 538 women who gave birth in the last 12 months preceding the survey were randomly selected for interview. Results: Data were obtained from 534 mothers, yielding a response rate 99.3%. Taking into account place of delivery identification, means of transportation and saving money, about 22% of the respondents were prepared for birth and its complications. In multivariate analysis, preparation for birth and its complication was higher among literate mothers (

The study showed little progress in the proportion of all births delivered by cesarean and a high rate of cesarean among women attended in the private sector--indicating a need to monitor the appropriateness of obstetric care in all sectors and to increase access in rural areas. Clinical management protocols for obstetric and newborn care are needed, and audits of cesareans should be performed at all institutions, especially in the private sector. The importance of improving record keeping is crucial for informed local decision-making.