Abstract
Antenatal care serves as a key entry point for a pregnant woman to receive a broad range of services and should be initiated at the onset of pregnancy. The World Health Organization recommends for the first antenatal visits to be before 12 weeks of gestation. However, many pregnant women due to various reasons attend first antenatal care services very late and little information is known on why pregnant women delay initiating antenatal care clinics during the first trimester. This study aimed to explore the perceptions of pregnant women contributing to the late initiation of antenatal care during the first trimester Ubungo Municipal Council.
 The study used purposive sampling to recruit thirty pregnant women for data collection through individual in-depth interviews. Pregnant women who attended antenatal care were recruited during antenatal care clinics and were interviewed in a room at the antenatal care unit. An in-depth interview was conducted with 30 pregnant women. Data were analyzed using thematic coding analysis.
 The finding of this study indicates that, lack of awareness on the appropriate time to start antenatal care first visit, pregnancy as a normal health condition which does not require health personnel attention, late identification of the pregnancy, transport cost and service cost as a barrier due to low income, long waiting hours at the facility, lack of support from the spouse and men’s working time table were major factors which pregnant women perceive to contribute late initiation in the antenatal care during the first trimester.
 Results conclude that, community awareness-raising and training on the significance of early antenatal clinic (ANC) visits are needed. Stakeholders should also address factors affecting facility and service levels such as high service costs and long waiting times at healthcare facilities.
Highlights
Antenatal care is one of the strategies that have been found crucial for ensuring optimal care and good maternal and fetal health
The study aims to explore the contributors to poor antenatal care attendance in the first trimester among pregnant women in Dar- es- salaam Tanzania, our findings show that inadequate knowledge in couples on when and importance of utilization of Antenatal care services, economic status, and antenatal policy were the major contributors to poor antenatal care attendance in the first trimester
Women in Ubungo Municipal council have provided information on the various aspects of late antenatal attendance at Sinza Palestina hospital in the Ubungo Municipal such as Inadequate Knowledge Of Couples On Antenatal Services In The First Trimester, Financial difficulties among pregnant women as a barrier to the initiation in antenatal care services during the first trimester and antenatal care policy and the health system as a barrier contributing to late initiation in the antenatal care services during the first trimester
Summary
Antenatal care is one of the strategies that have been found crucial for ensuring optimal care and good maternal and fetal health. It is estimated that 295,000 women died from preventable causes related to pregnancy and childbirth, while 94% of these deaths occur in low and lower-middle-income countries [1]. Antenatal care is an opportunity to provide care for the prevention and management of existing and potential causes of maternal and newborn mortality and morbidity [2]. Studies show that in developing countries only 25% of pregnant women initiate their antenatal care first visit before 14 weeks gestation [4]. It has been shown that several factors hindered pregnant women to initiate early in antenatal care services such as economic status cause pregnant women to initiate late in antenatal care attendance for those with low economic status and those with a good economic status they tend to initiate early [7].
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