Information on, knowledge and utilisation of support services during pregnancy and after childbirth: cross-sectional analyses of predictors using data from the KUNO-Kids health study

BMJ Open. 2020 Oct 26;10(10):e037745. doi: 10.1136/bmjopen-2020-037745.


Objectives: To investigate mothers' knowledge and utilisation of antenatal and perinatal support services as well as predictors of knowledge and service utilisation.

Design: Cross-sectional study.

Setting: Prospective birth cohort in Regensburg, Eastern Bavaria, Germany.

Participants: 2455 mothers after delivery.

Outcome measures: Participants' knowledge of distinct antenatal and perinatal support services (poor vs good, defined by median split). Participants' use of antenatal services provided by midwife (yes, no) and of any other antenatal support services (yes, no).

Results: The vast majority of mothers knew at least some support services. Two-thirds of women (68.4%) reported to have used the services provided by midwives. 23.6% of women reported to have used at least one of the other antenatal services. Good knowledge of services was associated with higher education (OR 1.37, 95% CI 1.13 to 1.67), no migration background (OR 2.26, 95% CI 1.76 to 2.90), better health literacy (OR 1.04, 95% CI 1.03 to 1.06), while being primiparous (OR 0.72, 95% CI 0.60 to 0.86) and being unmarried/living with a partner (OR 0.71, 95% CI 0.57 to 0.89) reduced the chance. Predictors of service utilisation differed with regard to the services considered.

Conclusions: Overall, mothers had a good level of knowledge of antenatal and perinatal support services. However, we found that some groups of women were less well informed. This inequality in social predictors of knowledge of services was also partly reflected in differences in service utilisation during pregnancy.

Keywords: community child health; epidemiology; maternal medicine; public health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cross-Sectional Studies
  • Female
  • Germany
  • Humans
  • Mothers*
  • Pregnancy
  • Prenatal Care*
  • Prospective Studies