Positive Relationships with Husband and In-Laws Linked to Women’s Use of Maternal Health Services

rather than some or many, difficulties with inlaws (odds ratio, 1.5). Among women in nuclear families, having no in-laws was associated with increased odds of hospital delivery (1.7); relationship quality with in-laws was not associated with facility births. Marital relationship quality was a predictor of maternal health care use only in nuclear families: Compared with women who reported many difficulties with their husband, those who reported very few were more likely to have obtained antenatal care (4.1) and delivered in a health facility (2.3); those with some difficulties also had elevated odds of a facility delivery (2.5). In nuclear families, the odds that women had obtained antenatal care or delivered in a facility were higher when covering household expenses during pregnancy was easy rather than difficult (odds ratios, 3.6 and 2.3, respectively); in joint families, finding it easy to meet expenses was associated only with antenatal care (2.2). In both types of families, women with some education were more likely than those with no schooling to have used maternal health services; the odds were particularly high among those with 10 or more years of education (5.1–14.8). Having a husband with at least 10 years’ education was associated with elevated odds of receiving services among women in joint families (1.7–2.1). Many of the associations between relationship quality and maternal health care use disappeared when measures of women’s agency were added to the model. In nuclear families, women without in-laws had elevated odds of hospital delivery in the expanded model (odds ratio, 1.8); however, the three other associations between relationship variables and maternal health care use were no longer significant once agency was taken into account. In joint families, the association between having a good relationship with in-laws and receiving antenatal care was reduced slightly after agency was accounted for (1.4). The results, according to the author, suggest that the association between relationship quality and health care use may depend in Positive Relationships with Husband and In-Laws Linked to Women’s Use of Maternal Health Services D I G E S T S