Timing and reasons for antenatal care booking among women in a tertiary health care center in Southern Nigeria


  • Ntiense Macaulay Utuk Department of Obstetrics and Gynecology, University of Uyo Teaching Hospital, Uyo-Akwa Ibom State, Nigeria
  • Anyiekere Ekanem Department of Community Medicine, University of Uyo Teaching Hospital, Uyo-Akwa Ibom State, Nigeria
  • Aniekan Monday Abasiattai Department of Obstetrics and Gynecology, University of Uyo Teaching Hospital, Uyo-Akwa Ibom State, Nigeria




Antenatal care, Early booking, Uyo


Background: Antenatal care is one of the four pillars of safe motherhood and its benefits in preventing adverse feto-maternal outcome is proven. Commencement of antenatal care early has been shown to be key for this benefit to be fully realized. The aim of this study was to determine the antenatal booking pattern of pregnant women and its determinants in our environment.

Methods: A cross sectional study of women attending the booking clinic in the University of Uyo Teaching Hospital, Akwa Ibom State, Southern Nigeria over a three-month period.

Results: The mean age of the respondents was 28.5 years. The mean gestational age at booking was 18.3 weeks. The majority of the patients were married (94.1%). 68.1% had a post-secondary education. 33.5% of patients were nultiparous, while 3.5% were grand multiparous. The majority of patients (72.4%) booked late for antenatal care. Age group, marital status, mode of delivery was not significantly associated with timing of booking. High levels of patient’s education, high levels of husband’s education as well as grand multiparity were significantly associated with late booking (P<0.05). Majority (65.4%) of patients claimed that it was safe to book at any time during pregnancy.

Conclusions: The majority of women booked late for antenatal care. In our study, we have found that general and health education, subsidisation of cost for antenatal care and introduction of focused antenatal care will help to reverse this trend.


Udofia I, Okonofua F. Preventing primary postpartum Haemorrhage in unskilled births in Africa. Afri J Reprod Health. 2008;12(1):7-9.

Barate P, Temmerman M. Why do mothers die! the silent tragedy of maternal mortality. Curr Women’s Health Rev. 2009;5:230-8.

National Population Commission. Nigeria Demographic and Health Survey. 2013. Maryland: NPC Nigeria; 2014.

Lincetto O, Mothebesocine-Anoh S, Gomez P, Munjanja SP. Antenatal Care. In: Lake J, Kerber k, editors. Opportunities for Africas Newborns: Practical Data, Policy and Programmatic Support for Newborn Care in Africa. Cape Town: PMNCH;2006

Why mothers die, 2000-2002. London: Confidential Enquiry into Maternal and Child Health. RCOG press;2004.

World Health Organization. Mother- Baby Package. Implementating safe motherhood in Countries. Practical guide. Document WHO/FHE/MSM/94.11 World health Organization; 1994.

WHO Antenatal care Randomised trial: Manual for Implementation of the New Model. UNDP/UNFPA/WHO/WORLD BANK special Programmes of research Development and Research Training an Human Reproduction. Geneva: Department of Reproductive health and Research family and Community Health, World Health Organization; 2002.

Okunlola MA, Ayinde OA, Owonikoko KA, Omigbodun AO. Factors influencing gestational age at antenatal booking at the University College Hospital, Ibadan. Nigeria J Obstet Gynecol. 2006;26:195-7.

Federal Ministry of Health Maternal Health and Obstetrics Fistula. Nigeria Demographic and Health Survey. Abuja, Nigeria. 2008:125-42.

Gharoro EP, Igbafe AA. Antenatal Care: Some characteristics of the booking visit in a major Teaching Hospital in the developing world. Med Science Monit. 2000;6:519-22.

Adekunle DA, Isawumi AI. Late antenatal care booking and its predictors among women in South Western Nigeria. Online J Health Allied Sci. 2008;7:4.

Ndidi EP, Oseremem IG. Reasons given by women for late initiation of Antenatal Care in the Niger Delta, Nigeria. Ghana Med J. 2010;44:47-51.

Charkraborty N, Islam MA, Chewdhury RI, Bari W. Utilisation of Postnatal care in Bangladesh: evidence from a longitudinal study. Health Social Care Community. 2002;10:495-502.

Gupta S, Yamada G, Mpembeni R, Frumence G. Callaghan-Koru JA et. al. Factors Associated with four or more antenatal care visits and its decline among pregnant women in Tanzania between 1999 and 2010. PLOS One. 2014;9(7):e101893.

Antenatal Care routine care for the healthy pregnant women. London; Royal College Obstetricians and Gynaecologists (RCOG) Clinical Guideline. RCOG Press; 2003.

Alemayehu T, Yilma M, Zewditu K. Previous utilization of service does not improve timely booking in antenatal care: Cross sectional study of timing of antenatal care booking at public health facilities in Addis Ababa. Ethio J Health Dev. 2010;24:226-33.

Ebeigbe PN, Igberese GO. Antenatal Care: A comparison of demographic and obstetric characteristics of early and late attendees in the Niger Delta, Nigeria. Med Sci Monit. 2005;11:529-32.

Oladokun A, Oladokun RE, Morhason Bello I, Bello AF, Adedokun B. Proximate predictors of early antenatal registration among Nigerian Pregnant women. Annals Afr Med. 2010;9(4):222-5.

Briggs N. Commentary. Maternal Health: Illiteracy and Maternal Health; Educate or Die. The Lancet. 1993.341:1063-4.

Abasiattai AM, Utuk NM, Udoma EJ, Umoh AV. Grandmultiparity: outcome of delivery in a Tertiary Hospital in Southern Nigeria. Nig J Med. 2011;20(3):345-8.






Original Research Articles