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 |