The rate of participation in standard pregnancy health care in China is gradually increasing, highlighting the imbalance and insufficiency in women's and children's health development between urban and rural areas. The potential of rural women's self-management as the cornerstone of pregnancy health care has not been fully utilized.

To examine the current status of standard pregnancy health care among rural women, assess their level of self-management behavior, and identify the factors influencing their self-management behavior in pregnancy health care.

The research was conducted from January to August 2023, involving rural women in Suihua City and Daqing City in Heilongjiang Province, as well as Changchun City in Jilin Province, all selected through convenience sampling. Various tools such as the Basic Information Questionnaire, Maternal Self-Management Scale, A5-item Short Form of the Edinburgh Postnatal Depression Scale (EPDS-Dep-5), and Maternal Social Support Scale (MSSS) were employed to gather data. Data in relation to the present condition of standard pregnancy health care among rural women were counted. The self-management behavior scores of different characteristics of rural women in pregnancy health care were compared. Multiple linear regression was used to assess the factors that impact rural women's self-management behavior in pregnancy health care.

A total of 493 questionnaires were distributed, and 470 valid questionnaires were collected, with a valid questionnaire collection rate of 95.33%. The findings revealed that 218 rural women (46.4%) underwent pre-pregnancy checkups, with 388 (82.6%) having their first checkups within 12 weeks. There were 303 cases (64.5%) where obstetric examinations took place in medical and health institutions at the county level or higher. Of 276 cases (58.7%), the number of obstetric examinations satisfied the requirements for the respective pregnancy week. However, only 103 cases (21.9%) adhered to the required number of obstetric examination items for the pregnancy week. The average score for self-management of health care during pregnancy was (70.18±16.42). The scoring indicators for each dimension, in descending order, were medical compliance behavior (79.75%), routine life behavior management (77.33%), self-protection behavior (76.73%), and fetal monitoring behavior management (70.43%). The findings from the multiple linear regression analysis indicated that the distance of family residence from the closest antenatal care facility (B=0.732, 95%CI=0.139-1.325), gestational week (B=-1.336, 95%CI=-2.119 to -0.553), pregnancy complications (B=3.776, 95%CI=1.532-6.019), risk of depression during pregnancy (B=-0.356, 95%CI=-0.663 to -0.049), and social support status (B=2.635, 95%CI=2.508-2.762) were identified as significant factors influencing the self-management behaviors of pregnancy health care among rural women (P<0.05) .

Rural women exhibited low rates of participation and eligibility for standardized pregnancy health care, along with moderate scores for self-management behaviors related to pregnancy health care. The distance of family residence from the nearest antenatal care facility, gestational week, pregnancy comorbidities, risk of depression during pregnancy, and social support were found to be the factors influencing the self-management behaviors of pregnancy health care among rural women. It is recommended that health care providers at all levels focus on rural women during pregnancy, standardize their pregnancy health care behaviors, enhance their self-management skills, and establish a scientifically sound, cost-effective, simple, and easily operable self-management intervention model for pregnancy health care among rural women.

我国规范孕期保健的参与率上升缓慢，城乡妇幼健康发展的不平衡、不充分问题突出，农村女性自我管理在孕期保健中的主体作用尚未能得到充分发挥。

调查农村女性规范孕期保健现状和自我管理行为水平，并分析其孕期保健自我管理行为影响因素。

于2023年1—8月，采取便利抽样方法选取黑龙江省绥化市、黑龙江省大庆市和吉林省长春市农村孕期女性作为调查对象，采用基本情况调查表、孕妇自我管理量表、简版爱丁堡产后抑郁量表（EPDS-Dep-5）和孕产妇社会支持量表（MSSS）对其进行调查，统计农村女性规范孕期保健现状，比较不同特征农村女性孕期保健自我管理行为得分，采用多元线性回归分析探讨农村女性孕期保健自我管理行为的影响因素。

共发放问卷493份，回收有效问卷470份，有效问卷回收率为95.33%。参加孕前检查的农村女性为218例（46.4%），首次产检时间在12周及以内的为388例（82.6%），产检地点在县级及以上医疗卫生机构为303例（64.5%），产检次数符合孕周要求的为276例（58.7%），产检项目数符合孕周要求的仅为103例（21.9%）。孕期保健自我管理得分平均为（70.18±16.42）分，各维度得分指标由高到低依次为遵医行为维度（79.75%）、日常生活行为管理维度（77.33%）、自我防护行为管理维度（76.73%）和胎儿监护行为管理维度（70.43%）。多元线性回归分析结果显示，家庭居住地距离最近定点产前检查医疗机构距离（B=0.732，95%CI=0.139~1.325）、孕周（B=-1.336，95%CI=-2.119~-0.553）、妊娠期并发症（B=3.776，95%CI=1.532~6.019）、孕期抑郁风险（B=-0.356，95%CI=-0.663~-0.049）和社会支持情况（B=2.635，95%CI=2.508~2.762）是农村女性孕期保健自我管理行为的影响因素（P<0.05）。

农村女性规范孕期保健的参加率和合格率较低，孕期保健自我管理行为得分处于中等水平。家庭居住地距离最近定点产前检查医疗机构距离、孕周、妊娠期并发症、孕期抑郁风险和社会支持情况是农村女性孕期保健自我管理行为的影响因素。各级医疗卫生服务人员应加强对农村孕期女性群体的重视，规范其孕期保健行为，提升其自我管理能力，构建科学适配、经济有效、简便易行的农村女性孕期保健自我管理干预模式。