Health Practices of Pregnant Women Attending Antenatal Clinics in the Western Cape, South Africa: A Cross-Sectional Survey
DOI:
https://doi.org/10.25159/2520-5293/19509Keywords:
antenatal clinics, health practices, pregnant women, positive health practices, abstaining from negative health practicesAbstract
Background: Health practices are the decisions and actions pregnant women take to manage pregnancy and health issues, reflecting self-care behaviours that influence maternal and neonatal outcomes.
Aim: To investigate the health practices of pregnant women attending antenatal clinics.
Setting: Selected antenatal clinics in primary healthcare facilities in the Western Cape.
Methods: A sample size of 267 pregnant women was drawn from three intentionally selected primary healthcare facilities in the Western Cape, chosen for their high antenatal attendance rates in the sub-district. The sample size was calculated using a sample size calculator, and respondents were selected using a systematic sampling method. A validated scale, Health Practices in Pregnancy Questionnaire-II, was used to collect data. Data were analysed per scale instructions using the Statistical Package for Social Sciences (SPSS) version 30 for descriptive and inferential statistics.
Results: The study achieved a response rate of 248 respondents. The respondents were on average 27.4 years old (sd=7.53), with 193 (77.8%) reporting that they attended secondary school. Just over half of the respondents (n=126, 50.8%) did not know the gestational age of their current pregnancy. Respondents had low health practices scores (108.11/170 (sd=9.17) [CI=95%: 106.96-109.26, range 83.80 to 138.80]. Positive health practices were rated higher than abstaining from harmful practices. No significant predictors of health practices were found.
Conclusion: Health practices should receive specific focus in health education activities.
Contribution: The authors recommend that nurses at antenatal clinics should educate pregnant women about the importance of health practices as part of self-care promotion.
References
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Brand, Judith S, Ayako Hiyoshi, Yang Cao, Deborah A Lawlor, Sven Cnattingius, and Scott Montgomery. 2020. “Maternal Smoking during Pregnancy and Fractures in Offspring: National Register-Based Sibling Comparison Study.” BMJ 368.
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Raisi, Dehkordi, Ziba, Shahnaz Kohan, Maryam Rassouli, Elahe Zarean, and Azadeh Malekian. 2020. “Developing a Perinatal Palliative Care Service Package for Women with Fetal Anomaly Diagnosis: Protocol for Mixed Methods Study.” Reproductive Health 17: 1–6.
Randriamboarison, Doriane, Elisa Fustec, Isabelle Enderlé, Mathilde Yverneau, Karine Le Breton, Linda Lassel, Nadia Mazille-Orfanos, and Patrick Pladys. 2024. “Qualitative Analysis of Mothers’ Perception Related to the Delivery of Information Regarding Preterm Births.” BMC Pregnancy and Childbirth 24 (1): 272.
Rezaei, Fatemeh, Zahra Zardosht, Yaser Sarikhani, and Tahereh Rahimi. 2025. “The Relationship between Self-Care and Health Locus of Control in Pregnancy: A Cross-Sectional Study of Iranian Women.” BMC Pregnancy and Childbirth 25 (1): 846.
Sedgh, Gilda, and Annik Sorhaindo. 2023. “Identifying and Prioritizing Evidence Needs in Self-Care Interventions for Sexual and Reproductive Health.” Frontiers in Global Women’s Health 4: 1148244.
Vogels-Broeke, Maaike, Darie Daemers, Luc Budé, Raymond de Vries, and Marianne Nieuwenhuijze. 2022. “Sources of Information Used by Women during Pregnancy and the Perceived Quality.” BMC Pregnancy and Childbirth 22 (1): 109.
WHO. 2025. Maternal Mortality. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality
Wu, Wan-Ru, Li-Chun Lee, Chich-Hsiu Hung, and Hui-Chuan Huang. 2024. “The Mediating Effect of Pregnancy Adaptation between Family Support and Maternal-Fetal Bonding: A Cross-Sectional Study.” BMC Nursing 23 (1): 350.
Adeoye, Ikeola A. 2022. “Alcohol Consumption and Tobacco Exposure among Pregnant Women in Ibadan, Nigeria.” BMC Psychiatry 22 (1): 570.
Adeoye, Ikeola, and Victoria Etuk. 2023. “Prevalence, Predictors and Pregnancy Outcomes of Unprescribed and Herbal Medicine Use in Ibadan, Nigeria.” BMC Complementary Medicine and Therapies 23 (1): 17.
Alhusen, Jeanne, Lauren Ayres, and Kelli DePriest. 2016. “Effects of Maternal Mental Health on Engagement in Favorable Health Practices during Pregnancy.” Journal of Midwifery and Women’s Health 61 (2): 210–216.
Asare, Sandra Fremah, Samuel Adjorlolo, and Petra Brysiewicz. 2025. “Prevalence and Risk Factors Associated with Common Mental Disorders among Pregnant Women in Kumasi, Ghana: A Facility-based Survey in Selected Primary Care Settings.” BMC Psychiatry 25 (1): 801.
Atilla, Rabia, Nazlı Baltacı, and Reyyan Gürel. 2024. “An Investigation into Health Literacy, Health Practices and Related Factors in Pregnant Women.” Journal of Academic Research in Nursing (JAREN) 10 (3).
Brand, Judith S, Ayako Hiyoshi, Yang Cao, Deborah A Lawlor, Sven Cnattingius, and Scott Montgomery. 2020. “Maternal Smoking during Pregnancy and Fractures in Offspring: National Register-Based Sibling Comparison Study.” BMJ 368.
Chatata, Amanda Grace, and Gowokani Chijere Chirwa. 2025. “The Impact of Multidimensional Poverty on Antenatal Care Service Utilisation in Malawi.” Health Economics Review 15 (1): 1–15.
Dayyabu, Aliyu L, and Mahmood K Magashi. 2020. “From Safe Motherhood to Sustainable Development Goals: Unmet Targets; What are We Missing?” Donald School Journal of Ultrasound in Obstetrics and Gynaecology 14 (1): 76–78.
Deniz, Muhammed, and Evrim Bayraktar. 2023. “Examining the Relationship Between Positive Health Behaviors and Quality of Life in Pregnant Women.” Sağlık Bilimleri Dergisi 32 (2): 292–300.
Erciyas, Şeyma Kilci, Ebru Cirban-Ekrem, Rukiye Demir, and Gize
Aköz. 2024. “Behaviors of Pregnant Women Regarding Travel–the Case of Türkiye.” European Journal of Clinical and Experimental Medicine 22 (1): 52–59. https://repozytorium.ur.edu.pl/handle/item/10356
Gülmezoglu, A Metin, Anne Ammerdorffer, Manjulaa Narasimhan, Alyce N Wilson, Joshua P Vogel, Lale Say, and Özge Tunçalp. 2020. “Self-Care and Remote Care during Pregnancy: A New Paradigm?” Health Research Policy and Systems 18: 1–3.
Hou, Keke, and Tingting Hou. 2022. “Investigating Pregnant Women’s Health Information Needs during Pregnancy on Internet Platforms.” Frontiers in Physiology 13: 1038048.
Iyawa, Gloria Ejehiohen, Aliyu Rabiu Dansharif, and Asiya Khan. 2021. “Mobile Apps for Self-Management in Pregnancy: A Systematic Review.” Health and Technology 11 (2): 283–294.
Karimi, Mehdi, Maryam Mofidi Nejad, Razieh Tabaeifard, Noushin Omid, Zahra Rezaei, and Leila Azadbakht. 2024. “The Association between Dietary Habits and Self-Care Behaviour of Pregnant Women with Pregnancy Complications.” Scientific Reports 14 (1): 19681.
Kiross, Girmay Tsegay, Catherine Chojenta, Daniel Barker, and Deborah Loxton. 2021. “Optimum Maternal Healthcare Service Utilization and Infant Mortality in Ethiopia.” BMC Pregnancy and Childbirth 21 (1): 390.
Khairy, Hazem Ahmed, Sijun Liu, Samar Sheikhelsouk, Ahmed M. EI-Sherbeeny, Omar Alsetoohy, and Bassam Samir Al-Romeedy. 2023. “The Effect of Benevolent Leadership On Job Engagement through Psychological Safety and Workplace Friendship Prevalence in the Tourism and Hospitality Industry.” Sustainability 15 (17): 13245.
Lindgren, Kelly. 2005. “Testing the Health Practices in Pregnancy Questionnaire–II.” Journal of Obstetric, Gynecologic, and Neonatal Nursing 34 (4): 465–472.
Montazeri, Maryam, Fatemeh Shabani, Ronya Rezaie, and Mojgan Mirghafourv. 2023. “Relationship between Health Practices with Attitudes towards Pregnancy and Motherhood and Pregnancy Symptoms in Iranian Pregnant Women: A Cross-Sectional Study.” BMJ Open 13 (9): e074048.
Mwakawanga, Dorkasi L, Beatrice Mwilike, Morie Kaneko, and Yoko Shimpuku. 2022. “Local Knowledge and Derived Practices of Safety during Pregnancy, Childbirth and Postpartum: A Qualitative Study among Nurse-Midwives in Urban Eastern Tanzania.” BMJ Open 12 (12): e068216.
Nguyen, Lam Duc, Long Hoang Nguyen, Ly Thi Ninh, Ha Thu Thi Nguyen, Anh Duy Nguyen, Linh Gia Vu, Hao Si Anh Nguyen, Son Hoang Nguyen, Linh Phuong Doan, and Thuc Minh Thi Vu. 2022. “Women’s Holistic Self-Care Behaviours during Pregnancy and Associations with Psychological Well-Being: Implications for Maternal Care Facilities.” BMC Pregnancy and Childbirth 22 (1): 631.
Okafor, Uchenna Benedine, and Daniel Ter Goon. 2021. “Physical Activity in Pregnancy: Beliefs, Benefits, and Information-Seeking Practices of Pregnant Women in South Africa.” Journal of Multidisciplinary Healthcare 787–798.
Onwuka, Chidinma I, Emmanuel O Ugwu, Chidozie I Onwuka, Emeka I Iloghalu, Ifeanyi E Menuba, and Peter C Udealor. 2020. “The Profile and Predictors of Early Prenatal Booking among Pregnant Women in Enugu, Southeast Nigeria.” International Journal of Medicine and Health Development 25 (1): 6–10.
Petty, Lisa, and Dawn E Trussell. 2021. “Leisure Self-Care, Health and Well-being in Women’s Lives.” Annals of Leisure Research 24 (3): 328–339.
Pratiwi, Dian Ika, Khairulisni Saniati, Silvia Finida Hannisa, Arum Seftiani Lestari, Atri Rudtitasari, and Asri Fitri Yati. 2025. “Factors Related to Maternal Mortality in Sintang Regency 2019–2023.” Journal of Educational Innovation and Public Health 3 (1): 98–106.
Raisi, Dehkordi, Ziba, Shahnaz Kohan, Maryam Rassouli, Elahe Zarean, and Azadeh Malekian. 2020. “Developing a Perinatal Palliative Care Service Package for Women with Fetal Anomaly Diagnosis: Protocol for Mixed Methods Study.” Reproductive Health 17: 1–6.
Randriamboarison, Doriane, Elisa Fustec, Isabelle Enderlé, Mathilde Yverneau, Karine Le Breton, Linda Lassel, Nadia Mazille-Orfanos, and Patrick Pladys. 2024. “Qualitative Analysis of Mothers’ Perception Related to the Delivery of Information Regarding Preterm Births.” BMC Pregnancy and Childbirth 24 (1): 272.
Rezaei, Fatemeh, Zahra Zardosht, Yaser Sarikhani, and Tahereh Rahimi. 2025. “The Relationship between Self-Care and Health Locus of Control in Pregnancy: A Cross-Sectional Study of Iranian Women.” BMC Pregnancy and Childbirth 25 (1): 846.
Sedgh, Gilda, and Annik Sorhaindo. 2023. “Identifying and Prioritizing Evidence Needs in Self-Care Interventions for Sexual and Reproductive Health.” Frontiers in Global Women’s Health 4: 1148244.
Vogels-Broeke, Maaike, Darie Daemers, Luc Budé, Raymond de Vries, and Marianne Nieuwenhuijze. 2022. “Sources of Information Used by Women during Pregnancy and the Perceived Quality.” BMC Pregnancy and Childbirth 22 (1): 109.
WHO. 2025. Maternal Mortality. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality
Wu, Wan-Ru, Li-Chun Lee, Chich-Hsiu Hung, and Hui-Chuan Huang. 2024. “The Mediating Effect of Pregnancy Adaptation between Family Support and Maternal-Fetal Bonding: A Cross-Sectional Study.” BMC Nursing 23 (1): 350.
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