BACKGROUND:
High-risk pregnancy complications contribute significantly to maternal and neonatal morbidity. Estimating their prevalence and understanding the challenges faced by pregnant women are essential to designing effective health programs that improve the health-related quality of life of women and children in Lebanon. Midwives play a critical role in providing prenatal home care, especially for vulnerable and hard-to-reach populations.

OBJECTIVES:
To explore the major barriers to accessing prenatal care among women with high-risk pregnancies in Lebanon, with particular emphasis on the role of midwives in delivering home-based interventions.

METHODS:
This is a secondary analysis of data collected through the “Prenatal Home Care for Women with High-Risk Pregnancies” project, implemented by LOM and supported by UNFPA. The care were provided by trained midwives across all Lebanese governorates. Multinomial logistic regression models were used to explore associations between key prenatal care challenges and high-risk pregnancy status. Ethical approval for the original data collection was obtained. Authors declare no conflicts of interest.

RESULTS:
A total of 895 pregnant women identified as high-risk participated in the study. Multiparous women reported higher rates of previous abortions and gestational complications compared to primiparous women. Severe high-risk pregnancies were significantly associated with geographic inaccessibility to health services (OR = 8.03, 95% CI [1.78–36.03]) and the high cost of transportation (OR = 0.14, 95% CI [0.02–0.86]). Midwives played a key role in reaching women who otherwise had limited access to facility-based prenatal care.

CONCLUSIONS:
Improving maternal and fetal health outcomes in Lebanon requires enhancing access to prenatal care for women with high-risk pregnancies. Midwifery-led prenatal home care represents an effective strategy to bridge access gaps and ensure equitable service delivery, particularly in underserved settings.

KEY MESSAGE:
Midwives are central to ensuring equitable, community-based prenatal care in Lebanon. Their efforts are essential for supporting high-risk pregnancies, detecting complications early, and improving outcomes for both mothers and infants. Poster session 1 (Group A)