Pregnancy wantedness, frequency and timing of antenatal care visit among women of childbearing age in Kenya

Abstract

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.

Determinants of Antenatal Healthcare Utilisation by Pregnant Women in Third Trimester in Peri-Urban Ghana

“…This indicates that the probability of regular visits to antenatal care facilities will increase by 4.1 percent if the age of the pregnant mother increased by one year. The result is in agreement with the findings of Arthur [15], Joshi et al [42], Godha et al [43], and Ochako and Gichuhi [44] that the increase in age of a pregnant mother increases the use of ANC. There is the need to educate young mothers on the need to utilise maternal care services including ANC.…”

Timing and number of antenatal care contacts in low and middle-income countries: Analysis in the Countdown to 2030 priority countries

“…A number of studies have explored reasons for no or delayed ANC initiation, and have included factors such as financial constraints, distance from the health facility, lack of knowledge about the recommended timing of ANC initiation, and socio-cultural factors such as lack of permission from spouse, late disclosure of pregnancy status, pregnancy wantedness [12][13][14][15][16]18,19,29,30]. These factors, in addition to the characteristics studied here of women falling behind in terms of timing and number of ANC, should be taken into consideration for specific ANC targeting and programmatic purposes.…”

“…Although the global coverage of one skilled ANC contact remains high at 86% [10], a substantially lower proportion of pregnant women initiate ANC during the first trimester [3]. Reasons associated with delayed ANC initiation include financial constraints, distance to health facilities, cultural and religious beliefs around disclosure of pregnancy status, gender norms, lack of awareness of pregnancy signs and antenatal care schedules, pregnancy wantedness, perceptions on the need to start ANC early, and quality of care received [1,[11][12][13][14][15][16][17][18][19].…”

Effects of planned, mistimed and unwanted pregnancies on the use of prenatal health services in sub‐Saharan Africa: a multicountry analysis of Demographic and Health Survey data

“…Others (e.g. ) also attest to the important association between pregnancy intentions and adequate ANC coverage. For example, Muhwava et al .…”