Journal of Nursing Palliative Care
Vol. 2 No. 1 (2026): March

The Effect of Education on the “Four Too’s” (4T) on the Knowledge Level of Pregnant Women in Preventing High-Risk Pregnancies in Simpang and Pauh Kurai Taji Villages, Pariaman City

Yohana Suganda (Universitas Sumatera Barat)
Ratih Septiana Arpen (Universitas Sumatera Barat)
Roza Ismarni (Universitas Sumatera Barat)



Article Info

Publish Date
30 Mar 2026

Abstract

The Maternal Mortality Rate (MMR) in Indonesia remains relatively high, recorded at 189 per 100,000 live births in 2022 (Ministry of Health RI, 2023). One of the main contributing factors is high-risk pregnancy, which is influenced by pregnant women’s limited knowledge of risk factors, particularly the concept of the Four Too (too young, too old, too frequent, and too many). This study aims to determine the effect of education about the Four Too on the knowledge level of pregnant women in preventing high-risk pregnancies in Simpang Village and Pauh Kurai Taji Village, Pariaman City. This research used a quantitative method with a pre-experimental approach and a one group pre-test and post-test design. The population included all pregnant women in Simpang and Pauh Kurai Taji Villages, with a sample of 15 respondents selected through purposive sampling. Data were collected using a questionnaire on knowledge of the Four Too and analyzed using the Paired Sample t-Test. The results showed that before the educational intervention, most pregnant women had a moderate level of knowledge (53.3%), and only 26.7% had a high level of knowledge. After the intervention, a significant improvement was observed, with 73.3% of respondents having high knowledge and none remaining in the low category. The paired t-test produced a p-value = 0.000 (p < 0.05), indicating a significant effect of the education on improving knowledge levels. It can be concluded that education about the Four Too is effective in increasing pregnant women's knowledge regarding the prevention of high-risk pregnancies. Therefore, educational interventions such as counseling and reinforcement through digital media are recommended to be routinely implemented by healthcare providers.  

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Journal Info

Abbrev

JNPAC

Publisher

Subject

Description

Journal of Nursing Palliative Care is a scholarly journal that publishes research articles, literature reviews, case studies, and best practice reports in the field of palliative nursing. The journal focuses on advancing knowledge and practice in nursing care for individuals with life-threatening ...