Haddad Diane N, Makin Jennifer D, Pattinson Robert C, Forsyth Brian W
Doris Duke International Clinical Research Fellowship, Yale University School of Medicine, New Haven, CT, USA; University of Pretoria MRC Maternal and Infant Healthcare Strategies, Pretoria, South Africa.
University of Pretoria MRC Maternal and Infant Healthcare Strategies, Pretoria, South Africa.
Int J Gynaecol Obstet. 2016 Jan;132(1):64-7. doi: 10.1016/j.ijgo.2015.06.041. Epub 2015 Sep 21.
To understand the barriers delaying early prenatal care for women in South Africa.
A mixed-methods study was conducted at a center in Pretoria.
Following interviews with 21 women at a prenatal clinic in Pretoria, a quantitative survey was completed by 204 postpartum women. During interviews, women described presenting late owing to contemplating induced abortion, fear of HIV testing, and fear of jealousy and bewitching. The survey results demonstrated that a majority of women (133 [65.2%]) reported knowledge of recommendations to present before 12weeks; however, the average gestational age at initial presentation was 19.1±7.7weeks. Women were more likely to present earlier if the pregnancy was planned (P=0.013) and were less likely to if they had at any point contemplated induced abortion (P=0.021). Fears of bewitching and harmful psychological stress owing to a positive HIV test result prevailed in both the interviews and the surveys.
Significant efforts should be devoted to improving access to contraception and prepregnancy counseling in order to improve early prenatal care attendance. Similarly, addressing cultural concerns and fears regarding pregnancy is imperative in promoting early attendance.
了解延迟南非妇女早期产前护理的障碍。
在比勒陀利亚的一个中心进行了一项混合方法研究。
在对比勒陀利亚一家产前诊所的21名妇女进行访谈后，204名产后妇女完成了一项定量调查。在访谈中，妇女们表示因考虑人工流产、害怕艾滋病毒检测以及害怕嫉妒和巫术而就诊较晚。调查结果显示，大多数妇女（133名[65.2%]）报告了解在12周前就诊的建议；然而，初次就诊时的平均孕周为19.1±7.7周。如果是计划内怀孕，妇女更有可能较早就诊（P=0.013），而如果她们曾在任何时候考虑过人工流产，则就诊可能性较小（P=0.021）。在访谈和调查中，对巫术的恐惧以及艾滋病毒检测结果呈阳性所带来的有害心理压力都很普遍。
应大力努力改善避孕措施的可及性和孕前咨询，以提高早期产前护理的就诊率。同样，在促进早期就诊方面，解决与怀孕相关的文化问题和恐惧至关重要。
