Medication practices among pregnant women and associated factors in Kiambu County, Kenya

Background: Unsafe medication use during pregnancy remains a public health concern in Kenya, yet self-medication is commonly practiced in many communities. Understanding what drives these behaviors can support preventive strategies and improve antenatal care outcomes. Methods: To determine medication practices among pregnant women in Kiambu County and identify the factors associated with those practices, a cross-sectional study was conducted among pregnant women attending antenatal care (ANC) at Kiambu County Level 5 Hospital. Data were collected using structured questionnaires and analyzed using descriptive statistics and inferential tests to assess associations (p<0.05). Results: Most women (88.2%) used medication during pregnancy; 46.1% reported self-medication without prescription, mainly from pharmacies (58.8%). Although 65.6% were generally aware of medication risks, only 27.6% received information from nurses. Distance to health facilities was significantly associated with self-medication, with women living 1–5 km from a facility being less likely to self-medicate (p<0.05). Cultural belief that some medicines “soften the fetus” significantly increased the likelihood of self-medication (p<0.05). However, sociodemographic factors, obstetric history and overall knowledge levels were not significantly associated (p>0.05). Conclusions: Medication use during pregnancy is common in Kiambu County and self-medication remains substantial. Cultural beliefs and health system access not sociodemographic or obstetric variables were the strongest drivers. Strengthening ANC counselling, addressing harmful cultural narratives and improving access to timely care may help reduce unsafe self-medication practices.