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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


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



Attributed to past/current medical condition


Lack of reproductive knowledge/pregnancy experience

Learning disabilities


Influence of others

Lay hindrance


Rejection of lay influence



Age affecting fertility


Past illness affecting fertility


Using contraception


Not planning, expecting to be pregnant







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



Lack of perceived value of antenatal care

(Good) past experience of pregnancy

Previous concealed pregnancy/late booking


Feeling well



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






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


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



Rationalising the delay

Trusting healthcare professionals


Feeling well, care not important


Influence of family and friends