There have been significant improvements in antenatal care worldwide – but in terms of provision of care, rural areas still lag well behind urban areas.

At least two thirds of women in every region see a skilled health provider one or more times during pregnancy.Antenatal care coverage has improved in every region since 1990. Women living in rural areas are, however, much less likely to receive antenatal care than their urban counterparts. For example, in the developing world as a whole, just one third of rural women receive four or more antenatal care visits, the number of visits recommended by WHO, compared with two thirds of urban women.

Nevertheless, there are indications that the gap in antenatal care coverage between rural and urban areas is narrowing. Between 1990 and 2008, the proportion of rural women in the developing world benefiting from at least one antenatal care visit rose from 52 to 67 per cent, a greater improvement than the 80 to 89 per cent increase among urban women.

There is also an urban-rural gap in contraceptive use in many developing regions. The gap is particularly large in sub-Saharan Africa, where just 18 per cent of rural women and 31 per cent of urban women are using any method of contraception. This is also the region with the highest levels of unmet need for family planning, with a greater percentage of women than in any other region who say that they would like to delay or avoid another pregnancy but are not using any contraception.

Adolescent girls from the poorest households are more likely than those from the richest households to begin childbearing early. In Madagascar they are four times more likely, and in Sierra Leone they are about three times more likely.