Perceptions of pregnant women of reasons for late initiation of antenatal care: A qualitative interview study

Abstract

Background: Antenatal care serves as a key entry point for a pregnant woman to receive a broad range of services and should be initiated at the onset of pregnancy. The aim of the study was to understand the reasons for the late initiation of antenatal care by pregnant women in Nkwen Baptist Health Centre, Cameroon. Methods: The study applied purposive sampling to recruit eighteen pregnant women and three key informants for data collection through individual interviews. Pregnant women who initiated antenatal care after the first trimester were recruited during antenatal care clinics and were interviewed in a room at the Antenatal Care Unit. Key informants were midwives working at the Antenatal Care Unit. Participation in the study was voluntary. The purpose of the study was explained to participants, and they signed a consent form if they were willing to participate in the research. Data were audio-recorded and analyzed using thematic coding analysis. Results: Pregnant women placed a low value on early antenatal care because they perceived pregnancy to be a normal health condition or to not be a serious issue that required seeking health care. Furthermore, previous positive pregnancy outcomes for which women did not access care made them less motivated to initiate antenatal care early. Participants perceived the booking system to be user-unfriendly and complained of overcrowded conditions, long waiting times and some rude service providers. The cost of services and distance to health facilities that required travel via uncomfortable transport on poor road networks were identified as perceived barriers. The absence of effective community health programmes, perceived lack of support from parents and spouses, fear of bewitchment and stigma due to cultural beliefs about the early initiation of antenatal care were also identified as variables influencing late initiation. Conclusion: Pregnant women lack information on the purpose of early antenatal care. Health facility barriers as well as socio-cultural beliefs have significant influences on the timing of antenatal care initiation. The government of Cameroon should strengthen the health system and implement activities to engage communities in improving care seeking for antenatal care and thereby improving maternal health status of women.

Spatial distribution and associated factors of antenatal care utilization in Ethiopia in 2019: Spatial and multilevel analysis

“…Women utilizing ANC was decreased among pregnant the than that of not/unsure of pregnancy. This finding inline other study (29). The possible explanation might be women initiated antenatal care late because they wanted to delay making the pregnancy public, because of fear of perceived "enemies" who could harm their pregnancies.…”

Psychosocial Influences on Pregnancy and Childbirth Behaviors in Northwestern Nigeria: A Cross-Sectional Analysis

“…The perception that ANC is only necessary if illness complications arise aligns with previous research suggesting that women often perceive pregnancy as a normal condition and place low value on antenatal care when feeling well. (27,28) It also dovetails with the most common reason cited by women in our study for non-use of ANC services, notably a lack of perceived need. SBC programs may therefore need to reinforce the importance of ANC to women and children even during healthy pregnancies without complications.…”

An Investigation into the Quality of History Taken During Antenatal Care in Selected Clinics of Lundazi District - Zambia

“…DISCUSSION Effective pre-, intra-, and post-natal care interventions play an important role in reducing child mortality and morbidity (Arunda et al, 2017). Antenatal care also called pre-natal care serves as a key entry point for a pregnant woman to receive a broad range of services should be initiated at the onset of pregnancy (Warri and George, 2020). During pre-natal care, comprehensive history taken at both initial and subsequent ANC service provision increases the chance of risk identification which eventually leads to early diagnosis and treatment.…”