BackgroundA woman’s health seeking behaviour during pregnancy has been found to have significant repercussions on her wellbeing and that of her unborn child. For example, the risk of poor pregnancy outcomes and maternal death is higher among women who do not receive antenatal care.MethodsThe study described the characteristics of women who reported wanted, unwanted and mistimed pregnancies from their last birth at the time of the survey; the linkage between frequency of antenatal care visits and pregnancy wantedness and the relationship between timing of the first antenatal care visit and pregnancy wantedness since maternal morbidity and mortality are higher among women who do not receive antenatal care. The 2008-09 Kenya Demographic and Health Survey data is used and multinomial logistic regression and logistic regression informed the study analysis.ResultsResults showed that women, who reported wanted pregnancy were more likely to receive antenatal care while those who reported unwanted pregnancy were less likely to receive antenatal care, but more likely to attend late the first time and have fewer than four antenatal care visits. Also, mistimed pregnancies were associated with low frequency of antenatal care visit and late timing of the first visit.ConclusionOur findings confirm an association between pregnancy wantedness, frequency of antenatal care visits and timing of the first antenatal care visit. Women whose pregnancy was reported as mistimed and unwanted were more likely not to receive any antenatal care and when they did; they went for fewer than the recommended four visits with late timing. Health policy and strategies should ensure that all pregnant women regardless of their pregnancy status at the time of conception first receive antenatal care, and receive it in a timely manner and make at least four antenatal care visits before delivery. This will help to identify health complications that may arise during and after delivery and reduce maternal, new-born and infant mortality. Information, education and communication campaigns on family planning especially for spacing and matters related to antenatal care visits, timing and frequency should be intensified nationally.

The first objective of this research was to explore the role played by traditional birth attendants (TBAs) during pregnancy and childbirth. The second objective was to establish perspectives of pregnant women regarding the role played by TBAs during childbirth. Eight TBAs out of 12 were selected using simple random sampling technique. These 8 TBAs were drawn from the environs of 10 sampled health facilities. To calculate the sample size for the pregnant women to be interviewed about their perspectives towards TBAs from the 10 sampled health facilities , this formula was used, 1230 x 15/100=184.5 rounded up to 185. According to 2009 census, the population of women at child bearing age (15 – 49 years) was 1230 in Kitui West Sub-County (KNBS et al.; 2009). The final sample size for pregnant women was 187 as shown under the discussion on sampling techniques. An in depth individual interview guide was used to gather information from the 8 TBAs and 165 pregnant women. Unstructured interview guide was used to gather information from 22 respondents who formed focus group discussion (FGD). To make a meaning from the raw data, it was transcribed and emerging themes and patterns according the objective of the study were picked. The Chi-square test analysis showed that more than a half of the women preferred to deliver at home assisted by a TBA. (χ2=1.572; df=2; p=0.036) where p=0.05. This was confirmed by the fact that 37 percent out of 135 respondents who attended ANC clinic and 90 percent out of 30 respondents who did not attend ANC clinic delivered at home assisted by TBAs.

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