IntroductionThe prevalence of periodontal disease among Sri Lankan women in the reproductive age group is considerably high. The present study aimed to assess the oral hygiene status, gingival status, and the associated factors among pregnant women attending community Antenatal Clinics (ANC) in Sri Lanka, against the challenging sociopolitical backdrop.MethodsThis cross‐sectional study was conducted among 576 pregnant women attending community ANCs within a specific Medical Officer of Health area in Sri Lanka. The clinics were selected using a two‐stage cluster sampling method with probability proportionate to size technique. Pregnant women were recruited from each clinic using a systematic sampling method. Data was collected with an interviewer‐administered questionnaire and an oral health examination form.ResultsPoor oral hygiene was detected among over 60% of pregnant women. Moderate‐to‐severe gingivitis was seen among 23.3% of them. Nearly 67% of the participants demonstrated limited knowledge of periodontal diseases. Approximately, 67% of them were unemployed, and 32.5% had a monthly income of less than 40,000 Sri Lankan rupees. Regression analysis revealed that the trimester, socioeconomic factors, frequency of dental visits, recency of full mouth scaling, and knowledge of periodontal diseases predicted the oral hygiene status, and age, trimester, frequency of brushing, recency of full mouth scaling, and knowledge of periodontal diseases were significant predictors of gingival health. Particularly, individuals with a lower socioeconomic status experienced both poor oral hygiene and gingival health.ConclusionThe suboptimal oral hygiene and gingival health, limited access to dental care, and inadequate periodontal health knowledge, highlight an urgent need for interventions such as empowering young women through educational and employment initiatives.