BACKGROUND AND AIMS: Maternal health is a crucial component of public health, with antenatal care (ANC) services essential for positive pregnancy outcomes. However, many women in low-income, marginalized populations face barriers to accessing this care. This cross-sectional study aims to investigate the factors affecting maternal health and ANC utilization among working mothers in southwestern coastal regions of Bangladesh. METHODS: Utilizing a structured questionnaire, data were collected from 220 working mothers from coastal regions, ages 16-45, who participated in the study. Reliability statistics and multivariate logistic regression analyses were used to identify the factors contributing to utilizing ANC. Adjusted odds ratio and 95% confidence interval were computed to show the strength of the association more clearly. RESULTS: Many pregnant working women in coastal Bangladesh encounter problems with their maternal health, such as an insufficient proper ANC system (23.2%) and insufficient healthcare facilities (13.6%). In spite of the government's best efforts, inaccessibility (20%) is still a major barrier to ANC utilization, especially in outlying coastal regions. Ordinal logistic regression was used to find the association between socioeconomic characteristics and the ANC system. Cultural beliefs restricted pregnant women to healthcare access to 2.73 times more than other factors. In addition, distance to healthcare access was found to be 1.22 times more than other factors. We hope that the results of this study highlight the critical need for immediate, focused initiatives to improve maternal health outcomes and increase the use of ANC in coastal areas of Bangladesh. Findings highlight significant associations between socioeconomic factors and healthcare-seeking behavior, emphasizing the need for targeted interventions to improve maternal health outcomes in similar settings. CONCLUSIONS: Strategies to increase community awareness, expand access to ANC services, and improve accessibility should consider the unique requirements of coastal women.