thematic inductive approach [33]. To enhance trustworthiness and credibility, two researchers independently read all of the manuscripts, including the interview transcripts and field notes, line-by-line several times. Then, the researchers read and compared both the transcripts and the field notes for each focus group individually. Integrating the data obtained from the FGDs and the field notes enhanced the strength of the data analysis and increased the dependability of the findings. Sections that had similar meanings or shared similar ideas were then indexed with separate colors and codes to synthesize and confirm the themes and subthemes which emerged from the discussions and to ensure that the main areas of interest had been covered and verified by the participants. A consensus on the themes and categories was reached before a thematic map was created. The content analysis procedure was completed in the original language, Arabic, in order to conserve the credibility of the findings. Forward/backward translation of themes, subthemes, and quotes into English was then undertaken to resolve incongruity and achieve conceptual equivalency. Results The following themes and sub-themes emerged from data analysis. It is important to note that the discussants women from the three hospitals shared similar experiences and views of maternal-fetal and newborn care services. Perceived reasons for seeking antenatal care There was a general consensus among the groups on the importance of ANC services. Among the discussants, the most common reasons for seeking ANC services were to find out and avoid fetal anomalies and abnormalities at an early stage of pregnancy; to make sure that the fetus is in good health; to receive comprehensive care and follow-up sessions; to perform lab tests if necessary; to receive multivitamins, iron/folic acid supplements, and medications; and finally, to receive routine maternal checkups, including checkups for gestational diabetes and preeclampsia, and thus avoid any related complications. One woman said: Table 1 Participant characteristics (Continued) Hospital C. In the ninth month ANC Alyahya et al. BMC Health Services Research (2019) 19:425 Page 5 of 16 “I usually visit my private doctor to carry out some medical exams, to make sure that my baby is safe and healthy, and to check up on my health.” Hospital B, FG2 Another woman added: “Yes, it’s important that I visit the clinic to avoid developing high blood pressure or diabetes during my pregnancy.” Hospital A, FG3. Private versus public maternal and neonatal care services Overall, it was found that most discussants preferred seeking private antenatal care services, whilst others found public sector care services to be satisfactory. Discussants who preferred private sector services gave several reasons for this. One woman stated: “The doctors in the private sector show me a detailed scan of my baby and carry out comprehensive checkups for me and my baby.” Hospital C, FG4 One mentioned reason for the non-comprehensive care in public sector care services was the lack of gynecologists and obstetricians. “We only have one doctor serving hundreds of women in the clinic…. there should be at least two doctors serving in such clinics.” Hospital C, FG4. Another woman, who criticized the antenatal services provided at public hospitals, said: “You spend a whole day at the hospital and all you get is a one- to two-minute check-up on the ultrasound, and the doctor doesn’t even talk to you.” Hospital A, FG3. On the other hand, many discussants were satisfied with the antenatal services provided at public hospitals: “When I visit the public clinic, I always receive good services, such as monthly medications and regular check-ups of my blood pressure. The problem there is that you have to wait for too long. However, they do provide you with everything you and your baby need, such as laboratory tests, medications, and so on.” Hospital B, FG1. “Every time I come to the public health center, they carry out all the necessary tests, such as blood pressure, diabetes, and so on. The only downside really are the long queues.” Hospital A, FG1. Another reason that encouraged some of the women to choose the private sector was that they believed that the multivitamins prescribed to them by private obstetricians were of higher efficacy than those available in public hospitals. Also, the women trusted laboratory results conducted in the private sector more than those conducted in public hospitals. “Sometimes, you carry out a urine analysis in a public hospital and receive results that don’t show any sort of infection, even though you’re sure that you have a Urinary Tract Infection. However, if you do the same test in a private clinic, you get a positive result. Visiting a private clinic is important if you want correct results.” Hospital C, FG2. Two other women confirmed this, saying: “Correct laboratory-test results are those you get from private laboratories. On the other hand, results that you get from public hospitals might be wrong due to the high demand on their labs … which could increase errors.” Hospital A, FG4. “I usually go to a public hospital for my routine monthly visits, but if I have to do laboratory tests or if I have a concern, I go to a private doctor.” Hospital A, FG1. There were disagreements among the discussants on the levels of competency of obstetricians in the private and the