BACKGROUND Antenatal care (ANC) provides healthcare services to pregnant women in an attempt to ensure, the best possible pregnancy outcome for women and their babies. Healthcare providers' understanding of their patient's behaviour and reasons for engagement in care and their response to this insight can influence patient-provider interactions and patient demand for ANC early in pregnancy. We examined the insight of healthcare providers into women's reasons for starting ANC later than the South African National Department of Health's recommended 20 weeks gestation. We also looked at the impact of late ANC presentation on overall healthcare providers' work experiences and their response in their interactions with patients. METHODS In-depth interviews were conducted with 10 healthcare providers at Maternal Obstetrics Units (MOU) and Primary Healthcare Centres (PHC) in Gauteng, South Africa. Healthcare providers were selected with the assistance of the facility managers. Data analysis was conducted using the qualitative analysis software NVivo 11, using a thematic approach of pinpointing, examining, and recording patterns within the data. RESULTS Healthcare providers were aware of patients need for secrecy in the early stages of pregnancy because of fears of miscarriage and women's preference for traditional care. Women with prior pregnancies presumed to know about stages of pregnancy and neglected to initiate ANC early. Barriers to early ANC initiation also include, women's need to balance income generating activities; travel cost to the clinic and refusal of care for coming after the daily patient limit has been reached. Healthcare providers encounter negative attitudes from un-booked patients. This has a reciprocal effect whereby this experience impacts on whether healthcare providers will react with empathy or frustration. CONCLUSIONS Timing of ANC is influenced by the complex decisions women make during pregnancy, starting from accepting the pregnancy itself to acknowledging the need for ANC. To positively influence this decision making for the benefit of early ANC, barriers such as lack of knowledge should be addressed prior to pregnancy through awareness programmes. The relationship between healthcare providers and women should be emphasized when training healthcare providers and considered as an important factor that can affect the timing of ANC.

中文翻译：

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产前护理迟到的原因，医疗保健提供者的观点。

背景技术产前护理（ANC）为孕妇提供医疗保健服务，以确保妇女及其婴儿获得最佳的妊娠结果。医疗保健提供者对患者行为和参与护理原因的理解以及他们对这种见解的反应可能会影响患者与提供者之间的互动以及患者在怀孕早期对 ANC 的需求。我们调查了医疗保健提供者对女性在南非国家卫生部建议的妊娠 20 周后开始 ANC 的原因的了解。我们还研究了晚期 ANC 演示对医疗保健提供者整体工作体验的影响以及他们在与患者互动中的反应。方法 对南非豪登省孕产科单位 (MOU) 和初级保健中心 (PHC) 的 10 名医疗保健提供者进行了深入访谈。在设施经理的协助下选择医疗保健提供者。使用定性分析软件 NVivo 11 进行数据分析，采用精确定位、检查和记录数据中模式的主题方法。结果 医疗保健提供者意识到患者在怀孕早期需要保密，因为担心流产以及女性偏爱传统护理。之前怀孕过的女性被认为了解怀孕的各个阶段，而忽略了尽早开始 ANC。早期启动 ANC 的障碍还包括：妇女需要平衡创收活动；前往诊所的交通费用以及在达到每日患者限额后拒绝接受护理。医疗保健提供者会遇到未预约患者的负面态度。这会产生交互作用，即这种经历会影响医疗保健提供者是否会做出同情或沮丧的反应。结论 ANC 的时机受到女性在怀孕期间做出的复杂决定的影响，从接受怀孕本身到承认 ANC 的需要。为了积极影响这一决策，使早期 ANC 受益，应在怀孕前通过意识计划解决缺乏知识等障碍。在培训医疗保健提供者时应强调医疗保健提供者与女性之间的关系，并将其视为影响 ANC 时机的重要因素。