How Mistimed and Unwanted Pregnancies Affect Timing of Antenatal Care Initiation in Three Districts in Tanzania

Amon Exavery, Ifakara Health Institute (IHI)
Colin Baynes, Columbia University and Ifakara Health Institute (IHI)
Ahmed Hingora, Ifakara Health Institute (IHI)
James F. Phillips, Columbia University

Although factors such as parity and age have been revealed as predictors of timing of antenatal care (ANC) initiation, pregnancy intentions is yet to be recognized. Cross-sectional household survey data collected in 2011 in Rufiji and Ifakara HDSS were used. ANC initiation was considered to be early only if it occurred in the first trimester of pregnancy. Multinomial logistic regression was conducted to examine how mistimed and unwanted pregnancies related with timing of ANC initiation. Mean age of 910 participants was 27.9 years. Of these, 49.3%, 34.9% and 15.8% reported having had intended, mistimed and unwanted pregnancies respectively in the past two years. Early ANC initiation was 18.5%. Regression analysis showed that delaying ANC initiation was significantly and independently more likely for mistimed and unwanted pregnancies compared with intended pregnancies. Late ANC initiation is an important maternal and child health consequence of mistimed and unwanted pregnancies in Tanzania.