Early antenatal care (ANC) booking and associated factors among pregnant women attending ANC services at public health facilities in Bahir Dar City Administration, Northwestern Ethiopia, 2023: a cross-sectional study

Antenatal care (ANC) is vital for improving maternal and fetal health by enabling the early detection and management of pregnancy-related complications. The World Health Organization recommends a minimum of eight ANC contacts to optimize maternal and neonatal outcomes and reduce perinatal mortality. Increased ANC contacts enhance the opportunity to identify and address potential complications, and studies show that eight or more ANC visits can reduce perinatal deaths by up to 8 per 1,000 births compared to fewer visits. Therefore, the main objective of this study is to assess early ANC booking and its associated factors among pregnant women attending antenatal care at public health facilities in Bahir Dar City Administration, Northwestern Ethiopia. Methods An institution-based cross-sectional study was conducted from October 1st to November 1st, 2023, involving 392 randomly selected pregnant women. Data were collected through interviewer-administered, pre-tested structured questionnaires. Binary and multivariable logistic regression analyses were used to identify factors associated with early ANC booking. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were reported, and statistical significance was set at p < 0.05. Results About one-third of participants (32.7%) initiated ANC early (95% CI: 28.3%–37.2%). The majority (92.3%) had at least a primary level of education, and 71.4% were aware of the importance of early ANC. Factors significantly associated with early ANC booking included maternal education (AOR = 1.62), receiving counseling on early ANC booking (AOR = 4.00), and obstetric history, specifically higher gravidity and parity (AOR = 1.55). Conclusion Early antenatal care (ANC) booking among pregnant women was found to be suboptimal. The key determinants of early antenatal care (ANC) booking included maternal educational status, receipt of counseling, and obstetric history, specifically gravidity and parity. These findings underscore the need for targeted health education interventions and individualized counseling approaches to promote early ANC engagement and enhance maternal health outcomes.