Abstract
Background: Nearly 800 women lose their lives daily because of complications concerning pregnancy, which is very common among underdeveloped and developing nations. However, many of these complications, which can lead to fatalities, are avoidable through quality antenatal care (ANC) during pregnancy and childbirth. Antenatal Care (ANC) is thus referred to as the medical and supportive care provided to a pregnant woman from the confirmation of conception until labour begins. Pregnant women’s satisfaction is a key global criterion for evaluating ANC quality, including in South Africa. Satisfaction with ANC reflects the extent to which a pregnant woman feels content with her care experiences, both within and beyond healthcare settings, which contributes to the establishment of consistent healthcare standards for the improvement of maternal and foetal outcomes.
Aim: The aim of this study is to assess the factors that influence pregnant women's satisfaction with ANC provided by midwives at a tertiary Hospital in KwaZulu-Natal.
Methodology: A quantitative, descriptive, cross-sectional survey design was used, with purposive and convenience sampling to recruit 311 pregnant women attending ANC clinics at the facility between September and October 2025. Data were collected via an adjusted survey instrument derived from the Patient Satisfaction Questionnaire Long Form (PSQIII), and the data were analysed via both descriptive and inferential statistical methods, including multivariable logistic regression analysis, to adjust for potential confounding factors independently associated with ANC satisfaction in the International Business Machine (IBM) Statistical Package for the Social Sciences (SPSS) version 30.
Results: The results showed a high rating mean score of 4.20±0.60 from the respondents with midwives’ technical skills, 4.12±0.52 with general satisfaction from specific aspects of ANC, 4.10±0.60 with interpersonal aspect, 4.06±0.65 with communication aspect, and 4.04±0.62 with accessibility (access, availability, convenience, and time spent during ANC) aspect of ANC. Furthermore, regression analysis revealed that the ANC factors predicted strong positive correlations. Accessibility (access, availability, convenience and time spent during ANC) emerged as the strongest predictor of satisfaction with specific aspects of ANC (β=0.512, p < 0.001) followed by technical skills (β=0.146, p < 0.007), and interpersonal caring attitude (β=0.129, p < 0.056) which significantly contributed to overall satisfaction.
Conclusion: Majority of the pregnant women in this study were satisfied with ANC provided by midwives at the hospital; thus, the results highlight the centrality of service accessibility (access/availability/convenience and time spent during ANC) and system efficiency in shaping women’s ANC experiences, alongside the importance of technical competence and respectful interpersonal communication. Recommendations: Given the high satisfaction ratings across all ANC dimensions, continued efforts are required to preserve clinical standards and further improve care delivery. Ongoing in-service training that strengthens midwives’ interpersonal and communication skills is essential. Additionally, improving service accessibility, addressing delays in care provision, and promoting respectful, woman-focused interactions may contribute to sustaining and enhancing maternal satisfaction with ANC.