KNOWLEDGE, DETERMINANTS AND PERCEPTION OF EARLY ANTENATAL BOOKING AMONG PREGNANT WOMEN AT IRRUA SPECIALIST TEACHING HOSPITAL, EDO STATE, NIGERIA

Abstract: Early antenatal care (ANC) initiation provides an opportunity for timely identification of maternal and foetal risks, preventive interventions and health education, yet delayed antenatal booking remains common in Nigeria. This study assessed knowledge, determinants and perceptions of early antenatal booking among pregnant women attending Irrua Specialist Teaching Hospital (ISTH), Edo State, Nigeria, using a hospital-based descriptive cross-sectional design among 275 pregnant women presenting for their first antenatal booking visit at ISTH between September 2022 and January 2023. Participants were recruited consecutively using a non-probability sampling technique, and data were collected using a pre-tested, interviewer-administered semi-structured questionnaire. Early booking was defined as booking at ≤14 completed weeks of gestation; data were analyzed using IBM SPSS version 26.0 and summarized using frequencies and percentages. Of the 275 respondents, 110 (40.0%) correctly identified the first trimester as the ideal time for antenatal booking, while 79 (28.7%) and 49 (17.8%) identified the second and third trimesters, respectively. Only 61 (22.2%) actually booked early, demonstrating a 17.8-percentage-point knowledge–practice gap. Regarding the timing of first medical review, 131 (47.6%) considered labour and delivery appropriate, while only 28 (10.9%) identified the first trimester. Doctors’ advice was the most frequently reported determinant of booking (66, 24.0%), followed by personal wish (43, 15.6%) and feeling that it was time to book (35, 12.7%). Financial constraint was reported by 18 (6.5%) respondents, all of whom booked late. Among perceived benefits of early booking, early detection of pregnancy complications was most frequent (107, 42.8%), followed by prevention and early treatment of disease (56, 22.4%). Reasons against early booking included the perception that pregnancy was too early for care and reluctance to disclose the pregnancy prematurely. Knowledge and perceptions of early antenatal booking were therefore not consistently translated into early booking practice; delayed booking appeared to reflect a combination of misconceptions, perceived absence of illness, financial constraints and individual and social influences. Targeted education, early pregnancy counselling, partner involvement and measures to reduce financial and access barriers are recommended to improve timely ANC utilization.