Premarital Childbearing, Unwanted Fertility and Maternity Care in Kenya and Namibia

Analysis of data from the 1993 Kenya and 1992 Namibia Demographic and Health Surveys shows that premarital childbearing is an important risk factor for the under-utilization of maternity care. In both countries, women with premarital births are significantly less likely than those with marital births to seek prenatal care in the first trimester. This relationship is not explained by wantedness or maternal age. Wantedness is not a significant determinant of the timing of the first prenatal visit or the likelihood of institutional delivery, except in Kenya where women are less likely to deliver at a health facility if they are dissatisfied with the timing of the pregnancy. Ethnicity plays an important role in conditioning the premarital birth effect on prenatal and delivery care. This finding suggests that cultural attitudes may shape the level of kin and social support for unwed mothers and, in so doing, have a direct impact on their perceived barriers to care.