Maternal Pregnancy Intention and Professional Antenatal Care Utilization in Bangladesh: A Nationwide Population-Based Survey

Abstract

ObjectiveTo investigate the association between maternal pregnancy intention and professional antenatal and delivery care utilization.MethodsOur data were derived from the 2011 nationally representative Bangladesh Demographic Health Survey. We included antenatal and delivery care utilization data of the most recent live births for women for the previous three years (n = 4672). We used multilevel logistic regression models to assess the relationship between pregnancy intention and use of professional antenatal and delivery care, with adjustment for potential confounding variables.ResultsApproximately 13% and 16% of children were reported by their mothers as unwanted and mistimed at the time of conception, respectively. Among the women, 55% received at least one professional antenatal care service; 21% received four or more professional antenatal services, while 32% were attended by professionals during deliveries. Mothers of children whose pregnancies had been unwanted had a greater risk for not seeking professional antenatal and professional delivery care than those whose pregnancies had been wanted [1≥ ANC from professionals: AOR: 0.66; 95% CI:0.51–0.93; 4≥ ANC from professionals: AOR:0.56; 95% CI:0.37–0.84; and delivery care from professionals: AOR: 0.70; 95% CI:0.50–0.97]. Women who were married after age 18, had secondary or higher level of education, and were from the wealthiest households were more likely to utilize antenatal and delivery care.ConclusionUnwanted pregnancy is significantly associated with lower utilization of professional antenatal and delivery care services in Bangladesh. Reducing unwanted births and promoting access to professional antenatal and delivery care are crucial for achieving the Sustainable Development Goals (SDGs) 3 in Bangladesh.

Unintended pregnancy and maternal health complications: cross-sectional analysis of data from rural Uttar Pradesh, India

“…One possibility is that women with unintended pregnancies are likely to recognize their pregnancy in a later stage, which means they miss the opportunity to access comprehensive maternal health services during pregnancy [41]. Another explanation could be that women with an unintended pregnancy may be less pro-active about seeking out health care [14]. Notably, the association between unintended pregnancy and maternal complications holds true even after accounting for health service utilization (ANC and ASHA home visits) during pregnancy.…”

“…Heightened maternal risk in Uttar Pradesh can be attributed, at least in part, to poorer maternal health care utilization, including antenatal care (ANC) [9]. Studies from India and elsewhere indicate that women with an unintended pregnancy are less likely to recieve ANC [6,[10][11][12][13][14][15][16]. In India, ANC care has received expanded attention via home visits to pregnant women by community outreach workers known as Accredited Social Health Activists-ASHAs, with a focus on socially vulnerable women (e.g., poorer, less educated, adolescents); although vulnerable women are more likely to be approached via ASHAs relative to clinicians, not all women are reached [17].…”

Cost comparison and determinants of out‐of‐pocket payments on child delivery care in Bangladesh

“…The study showed that the richest wealth quintile spent significantly more than poorest quintile, although higher cost does not always guarantee the better birth outcome . However, it was well reported that the wealthiest households always used more maternal care services than those in the poorest households, in the Bangladeshi context . Recent studies indicated that the utilization of C‐section was highly concentrated among mothers from the richest wealth quintiles, and even the poorest mother often had difficulties accessing this life‐saving procedure .…”

Does unwanted pregnancy lead to adverse health and healthcare utilization for mother and child? Evidence from low- and middle-income countries

“…To date, some studies (e.g. Marston and Cleland 2003;Wado et al 2013;Rahman 2015;Rahman et al 2016;Baschieri et al 2017;Echaiz et al 2018) have analysed the effect of unintended pregnancies on health and healthcare utilization in LMICs. However, the findings from these studies have been inconsistent.…”