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Table 4 Summary of women’s themes for late booking

From: Understanding delayed access to antenatal care: a qualitative interview study

Not knowing Realisation Delayed confirmation of pregnancy Lack of cardinal symptoms of pregnancy  
    Symptoms masked by irregular periods  
   Women’s misinterpretation/misdiagnosis of symptoms Attributed to other life event 'Mindset’
    Attributed to past/current medical condition  
    Lack of reproductive knowledge/pregnancy experience Learning disabilities
   Influence of others Lay hindrance  
    Rejection of lay influence  
  Belief Age affecting fertility   
   Past illness affecting fertility   
   Using contraception   
   Not planning, expecting to be pregnant 'Mindset’  
    Ambivalence  
Knowing Avoidance Fear and ambivalence Delay in confirming pregnancy  
    Fear of 'consequences’ of pregnancy Fear of removal of child
     Fear of stigma, judgement
   Coping mechanisms Denial, concealment In control of decision
    Antenatal self-care Using knowledge, experience
  Postponement Lack of perceived value of antenatal care (Good) past experience of pregnancy Previous concealed pregnancy/late booking
    Feeling well  
    Acceptance Fatalism, religion
    Antenatal self-care  
    'On the move’ Portability and timing of care
     Waiting until 'home’/in place of trust/safety
     Other priorities: no hurry’
     Practical difficulties accessing care
   Fear and ambivalence Fear of 'consequences’ of pregnancy Fear of judgement, reaction
     Convenience
     Denial
     Coping with another child
     Previous traumatic childbirth
     Fear of blood tests
    Considering termination Indecision resulting in delay
     Unplanned, unwanted pregnancy
   Pressure to have a termination Protecting the pregnancy In control of decision
Delayed Professional failures in primary care Misdiagnosis, misinformation   
   Mis-estimation of gestation   
  System failures Delay in referral process/scheduling of appointments   
   Lost appointments   
  Women’s knowledge and empowerment issues Not challenging the system Lack of knowledge of the antenatal care system 'Mindset’
   Rationalising the delay Trusting healthcare professionals  
    Feeling well, care not important  
    Influence of family and friends