A new study has linked advice given by mothers-in-law and husbands with pregnant women's participation in antenatal care.
Under-utilisation of available health services is one of a number of factors contributing to the high percentage of women dying during childbirth in Nepal.
Only 48% of pregnant women receive antenatal care and reasons for such low take up are poorly understood.
Aberdeen research student Ms Bibha Simkhada visited Nepal to find out more.
Her findings – which she has received a full scholarship to present at a prestigious sexual health conference in India later this month – draws attention to the influence mothers-in-law and husbands have in the decision-making process.
Ms Simkhada said: "The main aim of my study was to explore the factors affecting the uptake of antenatal care (ANC) in Nepal.
"I conducted in-depth interviews with 30 prenatal or postnatal mothers - half of whom were users of ANC and half non-users - and 10 husbands and 10 mothers-in-law in one urban community and one rural community."
She found that use of ANC was influenced by women's knowledge about reproductive health, past experiences of pregnancy, work loads (inside and outside the home), transportation costs and accessibility and availability of services.
But, she said poor communication between healthcare workers and pregnant women was a further factor, as well as affordability of care and relations within the family - especially with the mother-in-law.
"Interestingly, I found that family members, particularly husbands and mothers-in-law have strong influence in the use of ANC," explained Ms Simkhada.
"Sometimes this influence was positive, encouraging women to seek ANC but more often it was negative. A number of mothers-in-law had not used ANC themselves and did not see the benefits.
"On the whole, the use of ANC seems to be strongly influenced by socio-cultural factors and family supports. Interventions to improve the use of ANC should, therefore, target both women and family members."
Her paper is called 'Factors affecting utilisation of antenatal care in Nepal: Gender and family role in the decision-making process'.
Dr Edwin van Teijlingen, her supervisor, said: "Very little research has been conducted in Nepal in the reproductive health field, but studies elsewhere in Asia suggest this is a key area. Bibha's study will be of use not only to researchers and academics, but also to maternity care providers and health policy-makers."
The University of Aberdeen is involved in a large range of international health research and Ms Simkhada's study is one of a dozen or so postgraduate research projects conducted in Asia alone.
Added Dr van Teijlingen: "Bibha is a very bright PhD student and has already published one academic article and recently submitted her second one. I think the conference in India is a great opportunity to tell an international audience about her research."
Ms Simkhada will present her paper at the Fourth Asia Pacific Conference on Reproductive and Sexual Health and Rights from October 29-31 in Hyderabad, India. Her scholarship covers the conference registration fee, accommodation and expenses while she is in India.