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, Bamenda, 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.

‘They Forget I’m Deaf’: Exploring the Experience and Perception of Deaf Pregnant Women Attending Antenatal Clinics/Care

“…Amongst the nine participants, seven stated that they had registered late for their ANC. Registering a pregnancy and booking for antenatal care in the second trimester of pregnancy has been deemed an unsafe practice or attitude by pregnant women; unfortunately, the findings in this study showed that deaf pregnant women often registered late for ANC, in line with the findings of other stud-ies [4,5,[30][31][32]. This study showed that several factors were responsible for the late antenatal registration by deaf pregnant women.…”

“…Unlike the studies which reported that lack of knowledge contributed to late ANC initiation, this study confirmed that deaf pregnant women were knowledgeable about the importance of seeking care and the services offered at antenatal clinics [7,32]. In fact, one of the participants affirmed this with the following statement: "I know that going for antenatal visits is good.…”

“…This study appears to be the only one to have identified the role of distance to be travelled as a factor responsible for deaf pregnant women delaying seeking antenatal care. Studies among non-deaf pregnant women have, however, linked late registration of pregnancy and initiation of ANC to distance to health facilities [5,[32][33][34].…”

Risk Factors Associated With Frequency of Antenatal Visits, Number of Items of Antenatal Care Contents Received and Timing of First Antenatal Care Visits in Ethiopia: Multilevel Mixed-Effects Analysis

“…This study suggests that there is an urgent need to focus on mothers' education. The study also showed the need of advocating primary education for girls not to drop out from school and encourage them to pursue their secondary or higher education is essential in order to attain a tangible change to achieve the maternal and infant mortality reduction of the sustainable development goals through effective implementation of maternal health care services [32,47].…”

Developing targeted client communication messages to pregnant women in Bangladesh: a qualitative study

“…Although physical access has not been reported as a significant problem, utilization is low despite multiple efforts, including demand-side financing projects [ 10 ]. Women’s perceptions of care is a key issue limiting service utilization [ 11 , 12 ]. Women’s negative perceptions of the quality of ANC and the expectation that pregnancy complications are rare may prevent adequate ANC utilization.…”