Impact of pregnancy intention on antenatal care utilization and maternal outcomes in Jordan: evidence from a nationally representative survey

Globally, approximately half of all pregnancies are unintended, and this can have significant consequences for the health and lives of the mother, child, and the wider family. Unmet needs for sexual and reproductive health services, including antenatal care (ANC), are persistent, while wider societal, cultural, and religious factors impact rates of unintended pregnancies. The current study utilized data from 3743 female participants of the 2023 Jordan Population and Family Health Survey (JPFHS). The survey was used to report the rate of unintended pregnancy, and logistic regression models were developed to assess the factors associated with pregnancy planning, ANC utilization, and pregnancy complications. Among 3743 women included in the analysis, 20.7% reported their most recent pregnancy as unplanned. ANC utilization was generally high, with a median of eight visits and 92% completing at least four visits; however, women with unplanned pregnancies were significantly less likely to achieve adequate ANC. An unmet need for contraception was reported by 15% of participants. In adjusted models, age and region were associated with pregnancy planning status, while higher wealth and education were positively associated with ANC utilization. Unplanned pregnancy remained an independent predictor of lower ANC use. Age, particularly ≥ 35 years, was the only factor significantly associated with pregnancy complications. Unplanned pregnancy remains common in Jordan and is associated with reduced ANC utilization, despite overall high service coverage. Socioeconomic factors, particularly education and wealth, were positively linked to ANC use, while higher maternal age was the strongest predictor of pregnancy complications. These findings highlight the need for strengthened family planning services and targeted interventions to support older women and vulnerable groups in achieving equitable maternal health outcomes.