Overall, antenatal care attendance by mothers of Pacific infants living in South
Auckland is relatively high, with most mothers in the cohort attending at least one
antenatal care visit during their pregnancy. However, over a quarter of the mothers
initiated their antenatal care late or after the first trimester (in the 15th week of
pregnancy or later).
While not ideal, this finding is positive in comparison to previous research findings.
For example, a study of a cohort of New Zealand children born in 199112 found that
42.9% of the 238 Pacific mothers involved in the study initiated their antenatal care
late, and more recent investigations into late attendance have found that up to 70% of
Pacific women in South Auckland are attending late.19
Previous studies have defined late attendance as attending in the 13th week or
later.12,19 However, it is not likely that the 2-week discrepancy in time frames used
would account for such a large difference in late attendance. Further comparative
studies are needed as it is difficult to determine whether the current findings represent
an actual decrease in late attendance.
It is possible that funding constraints within the maternity care system may impact
upon the initiation of antenatal care. LMCs are not funded to provide a module of care
for pregnant women until the second trimester, and do not sign a care plan until this
time (fourteenth week of pregnancy).1
While this does not stop a woman from
attending visits to her GP or receiving advice from her midwife, this current system
may act as a disincentive to receiving early care for some women. Furthermore, some
women may experience a delay in registering with an LMC or receiving treatment if
their LMC of choice is fully booked.
The majority of mothers in the current study attended at least the minimum
recommended number of antenatal visits. Almost 11% of the mothers attended fewer
than 6 visits. This is comparable to research done by the National Health Committee
(NHC) in 1999, which found that 12% of Pacific women attended fewer than 6 visits,
compared to 6% of European women.4
The present study found that mothers of Pacific infants have similar demographic,
situational and psychosocial factors influencing the initiation and uptake of antenatal
care as found in previous research. However, different factors were involved in late
initiation of antenatal care and inadequate attendance.
Maternal gravida and parity were associated with late initiation of antenatal care, but
not attending fewer visits. High parity, indicating that the mother had experience
giving birth before, was associated with late initiation of antenatal care. This is in line
with previous research and suggests that these women feel that they do not need to
attend as early because they already know what to expect during pregnancy and
childbirth.8,11,12 These women may also have difficulty arranging childcare for other
children in their home in order to attend antenatal care.8
Mothers who reported this to
be their first pregnancy were more likely to initiate their care late, suggesting that lack
of knowledge or experience with pregnancy and childbirth is also a contributing factor
to late initiation of antenatal care. These mothers simply may not have recognised that
they were pregnant until later in the pregnancy.14