Discussion:
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The study attempted to assess the prevalence of women
who entered antenatal care (ANC) late in South Western
Nigeria in 2006 and identify related factors. Eighty one
percent of women entered ANC after 12 weeks of gesta-
tion. This was double the Australian study in 2004,20 but
similar to studies reported in other parts of the coun-
try.19 The mean gestational age at booking was still very
high but slightly lower than reports from studies in other
parts the country.17,19 This is far away from the recom-
mendation of World Health Organization thus the bene-
fits of early booking is not yet well appreciated.
Our results were similar to the findings from other stud-
ies on significance of age10, and maternal education.11
Women that were less than 25 years old, were less edu-
cated, earning lesser income and more unemployed than
the older women and were more likely to register late;
though after adjusting for other factors, income became
insignificant, this may still be due to traditional practice
of late booking in this environment due to the belief that
since pregnancy is not a diseased condition, thus reason
for indifference to early booking. Women that had lower
education or none booked later than those with higher
education, this agrees with studies in developed coun-
tries11,13,14 better educated women would likely appreci-
ate the importance of early booking more than the less
educated ones. This emphasizes the importance of edu-
cation on antenatal care. Previous obstetric complica-
tions such as still birth, eclampsia, intrauterine fetal
death; and caesarean section have no influence on gesta-
tional age at booking which were also reported in anoth-
er study in the country.19 This might be due to the nega-
tive effect of ignorance which had been demonstrated in
vicious circle of disease, ignorance and poverty.
In contrast to other studies in the country, illness in in-
dex pregnancy and nulliparity that were found to be sig-
nificantly associated with early booking had no influence
on gestational age at booking in this study,17,19 this might
be due to poor counseling of those who had illness in
the index pregnancy by the health workers they first had
contact with which were usually in low cadres that may
not necessarily have midwifery skill. Traditionally, nulli-
parous women in our environment would first seek
counseling from multiparous women who were consid-
ered to be more experienced and would eventually in
most instances discourage early booking as seen in this
study.
In conclusion, late booking still remain significantly high
in our environment indicating that the importance of
early booking is yet to be appreciated. Maternal educa-
tion and age which had been associated with better in-
come earning had been found to improve booking sta-
tus. There is need for public enlightenment and incorpo-
ration of the benefits of early booking in the routine an-
tenatal health education. Women empowerment through
qualitative education and gainful employment were also
major factors that would contribute significantly to early
booking.
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OJHAS Vol 7 Issue 1(4) Adekanle DA et al. Late Antenatal Care Booking And Its Predictors Among Pregnant Women In South Western Nigeria
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