Late registration for ante natal care by pregnant women with previous caesarean section

BackgroundDespite good access to antenatal care services for most women in Botswana, and regular training of health care workers in obstetrics and gynaecology, many pregnant women with previous caesarean section still presented late for antennal care at Letsholathebe II Memorial Hospital (LIIMH), in Maun, Botswana. Presenting late for antenatal care may lead to morbidity and mortality among pregnant women with previous caesarean section, and the babies they are carrying. Knowing the reasons why women with previous caesarean section present late for antenatal care may help in the formulation of interventions that decrease late presentation. Decreasing late presentation for ante natal care among pregnant women with previous caesarean section may decrease morbidity and mortality among these women and their babies.Aim The aim of the study was to explore the reasons why pregnant women with previous caesarean section registered late for ante natal care.SettingThis study was done at Letsholathebe II Memorial Hospital (LIIMH); a district a hospital situated in Maun Botswana.MethodsThis was a descriptive qualitative study. Consenting pregnant women who had a previous caesarean section delivery, were interviewed in the local language, until data saturation. These women presented at LIIMH, Maun, after the 20th week of pregnancy. The interviews were audio recorded, transcribed, translated into English and analysed thematically, using ATLAS-ti software.ResultsThe reasons that were raised by participants for late registration for antenatal care were lack of information, misconception on the appropriate booking time, and not knowing the place for their antenatal care. Participants’ dissatisfaction with the quality of clinic antenatal care, use of alternative antenatal care providers, delayed referral from local clinics, and experience from previous pregnancies were also mentioned as reasons for late registration.Discussion and ConclusionInadequate knowledge of antenatal care, and not knowing the planned place of delivery contributed to delays in registering for antenatal care at LIIMH. Dissatisfaction with antenatal care, and use of alternative antenatal care providers was another important factor. There is a need to keep pregnant women with previous caesarean section well informed about plans for their delivery, and for enlisting the help of alternative ante natal care providers, so as to improve management of pregnant women with previous caesarean section.