Factors Associated with Failure to Receive Antenatal Care

Abstract

EDITORIAL COMMENT: We seldom read why women in our community present late for antenatal care, fail to attend regularly or, heaven forbid, have no antenatal care at all. There are many countries where a large section of the population receives no antenatal care, even in nations where oil‐earned riches abound. It is an accepted fact that lack of antenatal care results in higher perinatal and maternal mortality nates. In Australia the causes of poor attendances are mainly socioeconomic (working mother, no baby minder, cost of fares), apart from general unreliability, and drug dependency with its associated problems. There is also the problem of communication with immigrant women who, in the editor's experience, are very cooperative and willing attenders when the aforementioned factors are not operative (some will attend only when accompanied by their husbands who speak better English, even when the hospital provides a good interpreter service). Nonattendance seems related more to poverty than ignorance ‐ this statement is an opinion and is not the result of the painstaking investigation that characterizes this paper from Thailand. The authors found that education of the husband is needed for his wife to receive the care she deserves; the details of maternal age and parity, and affluence of the family of these dwellers in 120 villages, in terms of antenatal attendance, should please readers with an interest in the problems faced by our colleagues in other lands. It also suggests that a careful audit of the causes of poor antenatal attendance and its sequelae should be undertaken in every community. The editor was surprised and dismayed to learn that at the Mercy Hospital for Women where he works such a study has not been conducted; provoked by this paper we will try to do better ‐ perhaps improvement of antenatal creche facilities may be the first priority required. Summary: A community‐based case‐control study was conducted to characterize pregnant women who did not receive antenatal care. 1,274 deliveries over a 1‐year period were documented by weekly visits to 120 study villages. Eighty five women (6.7%) received no antenatal care. By univariate analysis, factors found to be associated with failure to receive antenatal care included maternal age, paternal age, paternal education, home ownership, availability of toilet, annual income, housing condition, gravidity, parity, history of infant death and birth intervals. After logistic regression analysis, only paternal age, paternal education, parity and lack of toilet in the household were found to be associated with failure to receive antenatal care. Copyright © 1991, Wiley Blackwell. All rights reserved