Understanding delayed access to antenatal care: a qualitative interview study

Haddrill, Rosalind; Jones, Georgina; Mitchell, Caroline; Anumba, Dilly

doi:10.1186/1471-2393-14-207

Cited by 88 publications

(132 citation statements)

References 30 publications

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“…Therefore, in the Dodowa area, women who lived long distances from a health facility but experienced unwanted pregnancies could have been reluctant to walk to health facilities for ANC services. In addition, absence of a pregnancy ‘mindset,’ which is common in unexpected or unwanted pregnancy, could have exerted a negative influence on women’s use of ANC services [7,39]. …”

Section: Discussionmentioning

confidence: 99%

Determinants of attending antenatal care at least four times in rural Ghana: analysis of a cross-sectional survey

Sakeah

Okawa

Oduro

et al. 2017

Global Health Action

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Background: Improving maternal health is a global challenge. In Ghana, maternal morbidity and mortality rates remain high, particularly in rural areas. Antenatal care (ANC) attendance is known to improve maternal health. However, few studies have updated current knowledge regarding determinants of ANC attendance. Objective: This study examined factors associated with ANC attendance in predominantly rural Ghana. Methods: We conducted a cross-sectional study at three sites (i.e. Navrongo, Kintampo, and Dodowa) in Ghana between August and September 2013. We selected 1500 women who had delivered within the two years preceding the survey (500 from each site) using two-stage random sampling. Data concerning 1497 women’s sociodemographic characteristics and antenatal care attendance were collected and analyzed, and factors associated with attending ANC at least four times were identified using logistic regression analysis. Results: Of the 1497 participants, 86% reported attending ANC at least four times, which was positively associated with possession of national health insurance (AOR 1.64, 95% CI: 1.14–2.38) and having a partner with a high educational level (AOR 1.64, 95% CI: 1.02–2.64) and negatively associated with being single (AOR 0.39, 95% CI: 0.22–0.69) and cohabiting (AOR 0.57, 95% CI: 0.34–0.97). In site-specific analyses, factors associated with ANC attendance included marital status in Navrongo; marital status, possession of national health insurance, partners’ educational level, and wealth in Kintampo; and preferred pregnancy timing in Dodowa. In the youngest, least educated, and poorest women and women whose partners were uneducated, those with health insurance were more likely to report at least four ANC attendances relative to those who did not have insurance. Conclusions: Ghanaian women with low socioeconomic status were less likely to report at least four ANC attendances during pregnancy if they did not possess health insurance. The national health insurance scheme should include a higher number of deprived women in predominantly rural communities.

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Section: Discussionmentioning

confidence: 99%

Determinants of attending antenatal care at least four times in rural Ghana: analysis of a cross-sectional survey

Sakeah

Okawa

Oduro

et al. 2017

Global Health Action

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“…Increased maternal and neonatal risk levels were confirmed by different studies Wessel et al (2003); Haddrill et al (2014); Schultz and Bushati (2015). Neonaticide is also a rare but dramatic consequence of negation of pregnancy Craig (2004); Putkonen et al (2007); Huchzermeier and Heinzen (2015); Oberman (2003); Porter and Gavin (2010); Ellonen et al (2015).…”

Section: Introductionmentioning

confidence: 84%

“…In their study of the transition to first-time motherhood, Darvill et al identified changes in the woman's self concept as the major psychological issue associated to the maternal transition with three main themes: control, support and forming a family Haddrill et al (2014). The feeling of loss of control is related to different aspects; mostly frequent unpleasant physiological disorders in early pregnancy, rapid changes in body shape, reduced occupational freedom due to restricted mobility and additional mothering tasks and dependency on others.…”

Section: Psychological Issues In a Woman Who Becomes A Mothermentioning

confidence: 99%

“…The feeling of forming a family includes a sense of responsibility for the new life from very early in the pregnancy. This adjustment in self-perception from individuals or a couple into members of a new family is acknowledged as a fundamental transformation Haddrill et al (2014).…”

Section: Psychological Issues In a Woman Who Becomes A Mothermentioning

confidence: 99%

“…Hadrill et al emphasize on the social dimension of pregnancy by introducing the term of "social pregnancy" in their exploration of delayed access to antenatal care. They particularly state : "Women need a certain amount of approval and social support before their pregnancy can be acknowledged and accepted, both by the woman herself and her social network " Haddrill et al (2014).…”

Section: Psychological Issues In a Woman Who Becomes A Mothermentioning

confidence: 99%

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Evolutionary-rooted models for denial of pregnancy, concealment of pregnancy and pseudocyesis

Sandoz

Wessel

2018

Preprint

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Women in denial of pregnancy remain unaware of their gravid state. Typically women in labor present to emergency units while attributing their pain to unrelated causes. In higher risk cases, women experience unassisted delivery in a non-hospital setting. In concealment of pregnancy, the woman knows about her pregnancy but keeps it secret for diverse reasons. This induces also a lack of prenatal care and increased perinatal risks for mother and child. Such cases are very challenging to clinicians because of increased medical risk and psychological needs. Better understanding of these psychosomatic disorders is necessary to address the public-health issues raised. In regard to denial and concealment of pregnancy, in which a pregnant woman thinks or says she is not pregnant, pseudocyesis corresponds to the opposite configuration in which a non-pregnant woman believes, claims and presents objective signs to be pregnant. Pseudocyesis takes therefore place in the same psychosomatic issue to be addressed. This paper aims to explain satisfactorily these psychosomatic disorders of gravida status.We consider human reproduction in regard to evolution with emphasis on the various forms of parenting existing among sexually reproducing species. This evolutionary study highlights that for some pregnant women, the forthcoming maternal status may be internally appraised as psychologically-unacceptable because of diverse personalized causes. The ongoing pregnancy enters then into conflict with the intense fears triggered by the promise of motherhood. From this perspective, denial and concealment of pregnancy are satisfactorily explained as transitory means to cope with such an internal conflict by pursuing pregnancy while containing associated fears. In the absence of conflict resolution, the avoidance means is protracted over time, sometimes until an unexpected delivery. Reversely, pseudocyesis is explained as an attempt to obtain a psychologicallyindispensable maternal status in the absence of actual pregnancy. Specific conflict formulations are elucidated for each type of psychosomatic disorder of gravida status considered. These formulations, related to subjective internal appraisals, comply with the huge diversity of causative events reported in literature and specific to each woman concerned. These explanations will help clinicians in caring those high-demanding patients and in exploring individualized causative events of such challenging experiences.

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Provision and uptake of routine antenatal services: a qualitative evidence synthesis

Downe

Finlayson²,

Tunçalp

et al. 2019

Cochrane Database of Systematic Reviews

102

110

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Background Antenatal care (ANC) is a core component of maternity care. However, both quality of care provision and rates of attendance vary widely between and within countries. Qualitative research can assess factors underlying variation, including acceptability, feasibility, and the values and beliefs that frame provision and uptake of ANC programmes.  This synthesis links to the Cochrane Reviews of the effectiveness of different antenatal models of care. It was designed to inform the World Health Organization guidelines for a positive pregnancy experience and to provide insights for the design and implementation of improved antenatal care in the future. Objectives To identify, appraise, and synthesise qualitative studies exploring: · Women’s views and experiences of attending ANC; and factors influencing the uptake of ANC arising from women’s accounts; · Healthcare providers’ views and experiences of providing ANC; and factors influencing the provision of ANC arising from the accounts of healthcare providers. Search methods To find primary studies we searched MEDLINE, Ovid; Embase, Ovid; CINAHL, EbscoHost; PsycINFO, EbscoHost; AMED, EbscoHost; LILACS, VHL; and African Journals Online (AJOL) from January 2000 to February 2019. We handsearched reference lists of included papers and checked the contents pages of 50 relevant journals through Zetoc alerts received during the searching phase. Selection criteria We included studies that used qualitative methodology and that met our quality threshold; that explored the views and experiences of routine ANC among healthy, pregnant and postnatal women or among healthcare providers offering this care, including doctors, midwives, nurses, lay health workers and traditional birth attendants; and that took place in any setting where ANC was provided.  We excluded studies of ANC programmes designed for women with specific complications. We also excluded studies of programmes that focused solely on antenatal education. Data collection and analysis Two authors undertook data extraction, logged study characteristics, and assessed study quality. We used meta‐ethnographic and Framework techniques to code and categorise study data. We developed findings from the data and presented these in a 'Summary of Qualitative Findings' (SoQF) table. We assessed confidence in each finding using GRADE‐CERQual. We used these findings to generate higher‐level explanatory thematic domains. We then developed two lines of argument syntheses, one from service user data, and one from healthcare provider data. In addition, we mapped the findings to relevant Cochrane effectiveness reviews to assess how far review authors had taken account of behavioural and organisational factors in the design and implementation of the interventions they tested. We also translated the findings into logic models to explain full, partial and no up...

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Understanding delayed access to antenatal care: a qualitative interview study

Cited by 88 publications

References 30 publications

Determinants of attending antenatal care at least four times in rural Ghana: analysis of a cross-sectional survey

Determinants of attending antenatal care at least four times in rural Ghana: analysis of a cross-sectional survey

Evolutionary-rooted models for denial of pregnancy, concealment of pregnancy and pseudocyesis

Provision and uptake of routine antenatal services: a qualitative evidence synthesis

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