an examination of the role of antenatal care attendance in ...

Early care also allows for the development of interpersonal relationships between the health care
provider and the pregnant woman so that her particular needs and wants are known and expressed. In
countries where abortion is legal, early contact with the health system allows women with unwanted
pregnancies to be referred for safe abortion services (WHO 1996). However, several studies indicate
that most pregnant women in developing countries delay their first booking during pregnancy. In Sub-
Saharan Africa, studies have shown that women are more likely to report attendance between the
second and third trimester of their pregnancy (AbouZahr 1998).
In a study conducted in Ethiopia, out of 364 pregnant women, only one woman in the study began
attendance of antenatal care in her first trimester. The majority of women only visited a health facility
in their third trimester (Fantahum et al. 2000). A recent study in Bangladesh also shows similar results
where out of those who visited the antenatal care, the majority of pregnant women (66 percent) were
more likely to report their first attendance during the second trimester and above (Khan et al. 2005).
The same pattern is observed in Southern African countries. In Mozambique, almost 86 percent of
women reported that they did not initiate consultation during the first trimester of their pregnancy. The
majority reported initiating antenatal care between five to seven months, with the mean time of six
months (Chapman 2003). In Zimbabwe, a qualitative study found that almost 70 percent of women
reported that they had initiated consultation within the fifth month (Nielses 2000).
A qualitative study conducted in the Hlabisa district found that women were likely make their first
visit to the antenatal care clinic around median gestation age of 20 weeks (Myer and Harrison 2003).
Also, in KwaZulu-Natal, in the Empangeni area, Buch et al. (2003) found that of all pregnant women
who initiated antenatal care visits, only 15.3 percent had started antenatal care in their first trimester,
more than 68.4 percent had their first visit in their second trimester and about 16.3 percent in their third
trimester.
A study conducted by Varga (2001) in Durban found that the mean gestation age at first antenatal care
visit was more than 5 months and about 32 percent and 66 percent reported to initiating their first
antenatal care in the second and third trimester, respectively. The study also found that women were
likely to delay initiation of antenatal care by about four months between the discovery of pregnancy
and initiation of antenatal care (Varga 2001).
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