Background: Oral health care in pregnancy is crucial for the health of the mother and the unborn child. Pregnancy is associated with hormonal and behavioural changes that lead to dental problems, including gingivitis, periodontitis, and dental caries. Untreated oral diseases can lead to poor pregnancy outcomes and poor pregnancy-related quality of life. A regular dental check-up is recommended during pregnancy. The core objective of this study was to find out the factors associated with oral healthcare utilization among pregnant women at Kiambu level v hospital. Methodology: This was a cross-sectional study design targeting 308 pregnant women attending antenatal care clinics. Participants were selected through systematic random sampling, and data collected through a structured questionnaire. Data collected was on utilization of oral health services during pregnancy and factors affecting the utilization. Binary logistic regression was used to analyse data. Results: The study response rate was 99.3%. The age distribution of the pregnant women ranged between 18 and 45 years. Only 7.84% of the pregnant women had seen a dentist in their current pregnancy. The two key reasons cited for such a visit were routine check-ups and bleeding gums. Among patient-related factors, only education (p=0.008) had a statistically significant association with oral health care utilization. Among the health system-related factors, only access to oral health counselling (p = 0.010) was shown to have a statistically significant link with oral health care utilization. None of the sociocultural factors were found to be statistically significant. 6Conclusion: The undermentioned conclusions were made on the basis of this study's findings: (a) Very few pregnant women attending Kiambu level 4 hospital antenatal care clinics utilized oral health care; (b) There was a significant association between access to antenatal oral health counselling and oral health utilization; (c) There was a significant association between the women’s level of education and oral healthcare usage. Higher utilization was observed among those with a secondary level of education. Recommendation: 1). There is a need to include antenatal oral health microteaching in primary healthcare to improve oral health utilization among pregnant women. This oral health education should be available to all, irrespective of education level. 2). The study was conducted during the Covid-19 Pandemic, a follow up study to show if there will be any significant difference in numbers utilizing oral health care in pregnancy post Covid is recommended. 3). A larger sample size study and an additional qualitative method like focus group discussion highly recommended.

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