Psycho-social factors affecting antenatal care services utilization at the Ministry of Health’s primary health care centers in Jeddah, Kingdom of Saudi Arabia, 2017-2018: an analytical cross-sectional study

Background: This study aimed to explore the psychosocial factors affecting the utilization of antenatal care (ANC) services.Methods: This was an analytical cross-sectional study carried-out in the 4 main MOH maternity hospitals in Jeddah. The study sample included 2 groups: 80 women with inadequate ANC attendance and 159 with adequate ANC attendance. We applied probability proportional to size sampling technique. The outcome of this study was ANC attendance (adequate or inadequate). Independent variables included: age, nationality, educational level, occupation, monthly income, the dependent variables included: the number of ANC visits.Results: The utilization findings of this study revealed that 88 women out of 239 women had not fully used the health services provided to them (underutilization) and the utilization rate was 66.5%. Approximately one-half of the women with inadequate ANC had birth intervals of less than 2 years. Three-quarters of them reported that they did not plan their current pregnancies, and nearly two-thirds of them had high levels of stress. Logistic regression analysis indicated that inadequate ANC attendance was predicted by past negative experiences related to ANC attendance (p=0.001) (OR=0.183 CI=0.065-0.513).Conclusions: The most significant identified barriers to utilization of ANC services were high stress, previous negative ANC experience, unplanned pregnancy, and short birth intervals. Furthermore, women who had adequate ANC visits were more likely to have planned pregnancies and be aware of available ANC services.