Factors associated with the utilization and content of prenatal care in a western urban district of Turkey

Objective. To define the prenatal care utilization pattern in Bornova and determine the factors affecting the amount and content of prenatal care. Design. Follow-up study. Setting. Bornova is an urban district in western Turkey. Study participants. Two hundred and forty-five pregnant women registered with primary care settings in Bornova during the year 2000. Response rate was 83.7%. Main outcome measure. We determined the amount of prenatal care using Adequacy of Prenatal Care Utilization Index. Criteria used to assess the content of services include number of checks for maternal weight gain, blood pressure and foetal heart-beat measurements, advice about healthy lifestyles, laboratory examinations, and tetanus immunization. Results. Rates of the women who visited public primary health care settings, private care sources, and public hospitals at least once were 76.0, 57.1, and 54.6%, respectively. As to prenatal care, 64.9% of the participants received an adequate amount and 25.9% an adequate content. Parity (P = 0.00), insurance coverage (P = 0.00), abortion history (P = 0.03), husband’s occupation (P = 0.00), maternal age (P = 0.04), and level of educational attainment (P = 0.03) were related to the amount of care. Employment status (P = 0.03), continuous use of private sources (P = 0.00) and public hospitals (P =0.01) were associated with the content. Conclusion. This study has highlighted considerable associations between the amount of prenatal care and individual features in addition to those among the content of care, individual features and type of care sources. Causes of variations in prenatal care delivered in urban and relatively wealthy populations of developing countries must be explored using the appropriate criteria.