Understanding Barriers to Antenatal Care: A Comprehensive Review

A systematic review identifies socioeconomic, cultural, psychosocial, and health‑system barriers that interact to delay or reduce antenatal attendance and thereby increase perinatal risk.

Low household income, inadequate insurance or coverage, transport costs, and competing work demands are common socioeconomic drivers that delay first visits and reduce total visits. Cultural constraints — including traditional gender roles, stigma, and limits on women’s autonomy — further restrict care‑seeking and clinic attendance. These socioeconomic and cultural forces often reinforce one another, producing compounded barriers to early prenatal care.

Perinatal depression, anxiety, heavy caregiving responsibilities, and low social support reduce a patient’s capacity to schedule, attend, and adhere to recommended antenatal visits. Psychosocial burdens frequently cluster with socioeconomic strain and cultural pressures; the review highlights screening and accessible social supports as key strategies to reach affected women.

Long wait times, clinic hours that conflict with work, insufficient staffing, supply or referral gaps, and perceived low quality of care are service‑level deterrents that lead to drop‑off and late engagement. These failures delay risk identification and create missed opportunities for preventive interventions. They disproportionately affect marginalized groups, and health‑system barriers were consistently implicated across settings — signaling the need for system redesign and adapted workforce and support models.