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Objectives <p>This study examines the determinants and caste-based disparities of very early pregnancy awareness among Indian women using data from the National Family Health Survey-5 (NFHS-5, 2019–21).</p> Methods <p>Data were obtained from NFHS-5, a nationally representative survey of women aged 15–49 years in India. The analysis included 172,871 women. Very early pregnancy awareness was defined as awareness of pregnancy within the first month of gestation. Survey-weighted logistic regression models accounting for clustering, stratification, and sampling weights were employed to examine associations between very early pregnancy awareness and demographic, socioeconomic, and healthcare access-related factors. Additional caste-stratified analyses were conducted for Scheduled Tribes (ST), Scheduled Castes (SC), and Other caste groups. Supplementary analysis assessed the association between very early pregnancy awareness and timely antenatal care initiation within the first trimester.</p> Results <p>Higher educational attainment, household wealth, and perceived geographic access to health facilities were significantly associated with greater odds of very early pregnancy awareness. Compared with Scheduled Tribe women, Scheduled Caste women (AOR = 1.277, 95% CI: 1.202–1.356) and women belonging to Other caste groups (AOR = 1.390, 95% CI: 1.314–1.471) had significantly higher odds of becoming aware of pregnancy within the first month. Women with higher education had substantially greater odds of very early pregnancy awareness compared with women having no formal education (AOR = 1.764, 95% CI: 1.661–1.874). Women with very early pregnancy awareness were significantly more likely to initiate antenatal care within the first trimester (AOR = 1.406, 95% CI: 1.355–1.459).</p> Conclusions for Practice <p>Substantial caste-based and socioeconomic disparities persist in very early pregnancy awareness among Indian women. Improving female education and reducing geographic barriers to healthcare may enhance timely pregnancy awareness and antenatal care utilization.</p>

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Determinants and Caste-Based Disparities in Very Early Pregnancy Awareness Among Indian Women: Evidence from NFHS-5

  • 期刊论文

  • 发表日期：

    2026年7月17日

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  • Subhajeet Singh Sardar,
  • Mridul Mandal,
  • Subhasis Bhattacharya,
  • Shubhra Singh Sardar

摘要

Objectives

This study examines the determinants and caste-based disparities of very early pregnancy awareness among Indian women using data from the National Family Health Survey-5 (NFHS-5, 2019–21).

Methods

Data were obtained from NFHS-5, a nationally representative survey of women aged 15–49 years in India. The analysis included 172,871 women. Very early pregnancy awareness was defined as awareness of pregnancy within the first month of gestation. Survey-weighted logistic regression models accounting for clustering, stratification, and sampling weights were employed to examine associations between very early pregnancy awareness and demographic, socioeconomic, and healthcare access-related factors. Additional caste-stratified analyses were conducted for Scheduled Tribes (ST), Scheduled Castes (SC), and Other caste groups. Supplementary analysis assessed the association between very early pregnancy awareness and timely antenatal care initiation within the first trimester.

Results

Higher educational attainment, household wealth, and perceived geographic access to health facilities were significantly associated with greater odds of very early pregnancy awareness. Compared with Scheduled Tribe women, Scheduled Caste women (AOR = 1.277, 95% CI: 1.202–1.356) and women belonging to Other caste groups (AOR = 1.390, 95% CI: 1.314–1.471) had significantly higher odds of becoming aware of pregnancy within the first month. Women with higher education had substantially greater odds of very early pregnancy awareness compared with women having no formal education (AOR = 1.764, 95% CI: 1.661–1.874). Women with very early pregnancy awareness were significantly more likely to initiate antenatal care within the first trimester (AOR = 1.406, 95% CI: 1.355–1.459).

Conclusions for Practice

Substantial caste-based and socioeconomic disparities persist in very early pregnancy awareness among Indian women. Improving female education and reducing geographic barriers to healthcare may enhance timely pregnancy awareness and antenatal care utilization.