Health Care Attendance Patterns By Pregnant Women In Durban, South Africa

Abstract

Background High rates of perinatal mortality and morbidity and maternal mortality in South Africa remain a major problem. The Saving Mothers and Saving Babies Reports identified patient-related factors as possible causes. Among the patient-related factors was non-attendance, or attendance late in pregnancy, for antenatal care in public hospitals. It would appear that pregnant women confirm their pregnancies by visiting general practitioners, but do not attend antenatal care in the public sector. Aim The aim of this study was to determine healthcare attendance patterns among pregnant women in Durban, South Africa. Method This was a descriptive study. Participants were recruited and categorised into “early booker, “late booker and “unbooked in labour groups. All the participants were interviewed individually using a structured questionnaire. Results The majority of participants presented for formal “booking late in pregnancy; 47.9% “booked at a gestational age of six months after the last menstrual period. Among the “early bookers, the majority (94.4%) had confirmed their pregnancy by four months of amenorrhoea, and 60.6% of these confirmed their pregnancies within the public health sector. All the “early bookers began antenatal care prior to the 20th week of gestation. A total of 66.9% of the “late bookers and 66.7% of the “unbooked women also had their pregnancies confirmed at four months amenorrhoea, but 49.0% of the “late bookers and 59.8% of the “unbooked women confirmed their pregnancies in the private health sector. The “late bookers also showed a delay of two to three months between confirming the pregnancy and booking visits. Of the women in this study, 49% visited a general practitioner (GP) to confirm the pregnancy after two to four months of amenorrhoea. This figure rose to 53.0% if only the “late bookers and the “unbooked were analysed. Further, 35.3% visited a GP more than once, either for antenatal care or because of ill health. Conclusion It is imperative for GPs to understand the role of antenatal care and to refer pregnant women appropriately.