Utilization of Maternal Healthcare Services among Adolescent Mothers in Indonesia

Providing maternal healthcare services is one of the strategies to decrease maternal mortality. Despite the availability of healthcare services, research investigating the utilization of healthcare services for adolescent mothers in Indonesia is still limited. This study aimed to examine the utilization of maternal healthcare services and its determinants among adolescent mothers in Indonesia. Secondary data analysis was performed using the Indonesia Demographic and Health Survey 2017. Four hundred and sixteen adolescent mothers aged 15-19 years were included in the data analysis of frequency of antenatal care (ANC) visits and place of delivery (home/traditional birth vs. hospital/birth center) represented the utilization of maternal healthcare services. Approximately 7% of the participants were 16 years of age or younger, and over half lived in rural areas. The majority (93%) were having their first baby, one-fourth of the adolescent mothers had fewer than four ANC visits and 33.5% chose a traditional place for childbirth. Pregnancy fatigue was a significant determinant of both antenatal care and the place of delivery. Older age (OR 2.43; 95% CI 1.12-5.29), low income (OR 2.01; 95% CI 1.00-3.74), pregnancy complications of fever (OR 2.10; 95% CI 1.31-3.36), fetal malposition (OR 2.01; 95% CI1.19-3.38), and fatigue (OR 3.63; 95% CI 1.27-10.38) were significantly related to four or more ANC visits. Maternal education (OR 2.14; 95% CI 1.35-3.38), paternal education (OR 1.62; 95% CI 1.02-2.57), income level (OR 2.06; 95% CI 1.12-3.79), insurance coverage (OR 1.68; 95% CI 1.11-2.53), and presence of pregnancy complications such as fever (OR 2.03; 95% CI 1.33-3.10), convulsion (OR 7.74; 95% CI 1.81-32.98), swollen limbs (OR 11.37; 95% CI 1.51-85.45), and fatigue (OR 3.65; 95% CI 1.50-8.85) were significantly related to the place of delivery. Utilization of maternal healthcare services among adolescent mothers was determined by not only socioeconomic factors but also pregnancy complications. These factors should be considered to improve the accessibility, availability, and affordability of healthcare utilization among pregnant adolescents.