Background: Birth preparedness, recognition of obstetric and newborn danger signs, and timely care-seeking are central to safe motherhood. Brief digital reinforcement may extend the reach and repeatability of routine antenatal education.

Objective: To evaluate the effectiveness of a QR-code-integrated self-instructional kit in improving knowledge regarding birth-safety measures among antenatal mothers attending an antenatal outpatient department.

Methods: A one-group pretest-posttest study included 60 antenatal mothers selected by purposive sampling at SVS Hospital, Mahabubnagar, and Telangana. Participants completed a structured 30-item knowledge questionnaire, received a printed self-instructional kit supplemented by a QR-linked educational video, and completed the same assessment one week later. Knowledge was classified as inadequate (<50%), moderately adequate (50-74%), or adequate (>=75%). Paired t testing evaluated change in continuous scores, an exact paired sign test assessed the categorical direction of change. Exploratory chi-square associations were re-evaluated with exact p values and Holm adjustment for multiple comparisons.

Results: Mean knowledge increased from 9.83 +/- 1.74 to 22.22 +/- 2.10. The reported paired mean difference was 12.38 points (95% CI 12.25-12.51), t(59)=195.64, p<0.001. All participants were in the inadequate category at pretest, at posttest, 34 (56.7%) were moderately adequate and 26 (43.3%) were adequate. The exact sign test confirmed a uniform direction of improvement (p<0.001). Education and gravida showed nominal unadjusted associations with posttest knowledge category, but neither remained significant after Holm correction. A favourable birth-safety classification was recorded for 52/60 participants (86.7%, 95% CI 75.8-93.1%).

Conclusion: The QR-code-integrated self-instructional kit was associated with a large immediate improvement in birth-safety knowledge. The format is a practical adjunct to nurse-led antenatal counselling, while controlled studies with prespecified clinical outcomes are required to determine effects beyond short-term knowledge acquisition.