Reasons for late presentation of pregnant patients with previous caesarean section delivery at Letsholathebe the 2nd Memorial Hospital in Maun, Botswana: an exploratory qualitative study

Abstract

Introduction Maternal mortality and morbidity remains high worldwide due to chronic diseases and underutilization of maternal health services. Botswana has made progress in decreasing maternal deaths, but maternal mortality rate still remains high due to factors such as substandard care. Though antenatal care coverage in Botswana is high, late initiation of antenatal care remains a problem. At Letsholathebe II Memorial Hospital (LIIMH), it was observed that there was high mortality and morbidity among women with previous caesarean delivery who initiated antenatal care late. The aim of the study was to explore the reasons for late presentation of pregnant patients with previous caesarean delivery to LIIMH in Maun. Methods An explorative qualitative study was performed. Ten purposively selected pregnant women who had previous caesarean section delivery presenting for the first time at LIIMH, Maun, after the 20th week of pregnancy were interviewed. The interviews were audio recorded, transcribed, translated into English and analysed using thematic inductive process initially manually and later with ATLAS-ti ®© software. Data saturation was achieved at the point of 10th interview Results The reasons that were raised by participants for late presentation to LIIMH were lack of information and misconception on the appropriate booking time and the place for ANC; dissatisfaction with the quality of ANC and use of alternative ANC providers; delays at local clinics; experience from previous pregnancies and pregnancy related factors. Conclusion The study found several factors contributing to late booking among pregnant women with previous caesarean delivery at LIIMH. Consideration of these factors in provision of maternal health services could help improve timely antenatal care attendance.