Table 4 Summary of women’s themes for late booking

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