How Do Women Learn They Are Pregnant? The Introduction of Clinics and Pregnancy Awareness in Nepal

Abstract

The earlier a woman learns about her pregnancy status, the sooner she can make decisions about her own and infant's health. This paper examines how women learn about their pregnancy status and measures how access to pregnancy tests affects earlier pregnancy knowledge. Using  years of individuallevel monthly panel data in Nepal, we find that, on average, women learn they are pregnant in their .th month of pregnancy. Living approximately a mile further from a clinic offering pregnancy tests increases the time a woman knows she is pregnant by one week ( percent increase) and decreases the likelihood of knowing in the first trimester by . percentage points ( percent decrease). Women with prior pregnancies experience the most substantial effects of distance within the first two trimesters, while, for women experiencing their first pregnancy, distance does not affect knowledge. These results suggest that, while access to clinics can increase pregnancy awareness for women who recognize pregnancy symptoms, other complementary policies are needed to increase pregnancy awareness of women in their first pregnancy.  How Do Women Learn They Are Pregnant?1 A vast literature describes how access to pregnancy tests can increase the uptake of services. In our setting, Andersen et al. (2013) show that female community health volunteers in Nepal can use the result of UPTs to refer women to the appropriate services (antenatal care/abortion or contraceptive methods).