Abstract:
Background
The incidence of late initiation of antenatal care in South Africa remains high, despite the
reported benefits of early initiation of antenatal care and free antenatal care services since
1994. Antenatal care is a crucial strategy to reduce maternal and perinatal morbidity and
mortality. Whenever antenatal care is initiated late, the opportunity to prevent, detect and treat
pre-existing medical conditions and pregnancy-related complications becomes limited hence
contributing to maternal and perinatal mortality.
Aim of the study
The study aimed to explore and describe the reasons for late initiation of antenatal care among
pregnant women at a selected community health centre in Tshwane.
Research design and method
A narrative inquiry was conducted. Participants belonged to the same community. Data was
collected using semi-structured interviews among ten pregnant women who initiated antenatal
care after 20 weeks of gestational age at the selected community health centre. Interviews
were recorded, transcribed, and analysed according to thematic analysis.
Results
Individual stories were analysed to get the content of their accounts, then the meaning of all
the stories was collated to bring about the broad story of the reasons contributing to the late
initiation of ANC. Four central themes and ten sub-themes were identified. These are namely
unplanned pregnancy (unaware of pregnancy, contraceptive failure), work circumstances
(lack of opportunity to attend ANC and stress from work), dilemma of reporting (fear of
reporting and embarrassment) and service delivery issues (pregnancy confirmed somewhere
else, service delivery flow, shortage of staff and misdiagnosis of pregnancy).
Conclusion
Regarding the ANC received, participants were satisfied. None complained about nurses’
attitudes. The need for women empowerment concerning their reproductive health and rights
is very fundamental. There is a great need for motivating the use of Long Acting Reversible
Contraceptives among women in their reproductive ages, to prevent unplanned pregnancies.
ANC services should be extended to after hours and weekends to reach women struggling
with socioeconomic circumstances or disadvantages. Lastly, there should be regular
reinforcement and monitoring the implementation of existing policies to improve quality care.
