abstract: Social determinants of health present significant barriers to utilization of maternal health services in transitional countries. This dissertation study examined associations between household autonomy and utilization of prenatal services among women of reproductive age in Armenia and Azerbaijan. Using nationally representative survey data, this study explored if household autonomy of women positively influenced the timing of the first prenatal visit, the number of prenatal care visits, and the content of care during visits. Results showed that household autonomy was positively associated with the timing of the first visit for prenatal care and the number of prenatal care visits. The content of care was negatively associated with the autonomy of women. Findings also pointed to an endogenous influence of a woman's position in the household structure. Additionally, this study analyzed associations between women's reproductive history and utilization, and economic disparities in utilization of prenatal care. The findings demonstrated that a history of complications during pregnancy and stillbirths were positively associated with utilization of prenatal care. Economic disparities in utilization of care were identified. Future interventions to increase utilization of maternal health services should account for traditional household structures in transitional countries. Women from poor families should receive support from social assistance and the health sector in accessing services pertaining to their health and well-being. / Dissertation/Thesis / Doctoral Dissertation Social Work 2015