Abstract
This paper examines the unbooked maternity patient in an academic hospital in Durban, Natal. This hospital is the biggest hospital serving the underprivileged population of this area. Of the 16,000 annual deliveries in this hospital, about 12% are unbooked patients. The health belief model of Rosenstock, as interpreted by Mikhail, and Cox's interaction model of client health behaviour were used as a theoretical framework for this research. A qualitative case study methodology was undertaken and semi-structured interviews were conducted with unbooked mothers who had utilized appropriate health services in a previous pregnancy. The aim of such interviews was to explore reasons given by mothers for non-use of facilities in the current pregnancy. The basic trends reflected in the findings regarding non-utilization of health services were client instability, health service failure and socio-cultural constraints. The study is innovative and addresses the problem from a social-cultural and midwifery perspective.
Highlights
The health beliefmodel ofRosenstock, as interpreted by M ikhail and Cox’s interaction model ofclient health behaviour were used as a theoreticalframeworkfor this research
Studies previously carried out in this institution have indicated that unbooked patients deliver more low birth weight infants, have a higher perinatal mortality and born-before-arrival (B.B.A.) rate than mothers who are booked patients
Larsen and Van Middelkoop (1982) observed that 35% of the women delivering in this hospital were unbooked, and Loening and Broughton (1984) noted that 19.4% of the neonates in the neonatal nursery of the hospital were delivered of unbooked mothers
Summary
Comparative studies of booked and unbooked patients demonstrate that the unbooked patient is a woman with limited resources and that pregnancy outcome from unbooked clients is often high risk (Loening and Broughton 1985, Pattison and Rossouw 1985). Conco (1972) gave an interesting account of how a woman who considers herself to be having ‘ipuieti’ (a blanket term for all obstetric com plications such as pregnancy induced hypertension, antepartum haemorrhage, post-partum haemorrhage, cephalo-pelvic disproportion, puerperal sepsis, still births and neonatal deaths and a wide range of unexplained maternal fetal and neonatal complications) as diagnosed by a family member or traditional healer, would start antenatal dinic attendance early to see if the medical practitioner or nurse at the clinic diagnoses her problem or not If they refute the existence of ipuieti as unscientific and unfounded, the patient may be so discouraged and so distrustful of the medical practitioner or nurse that she may never return to the health service. 2) Factors related to the perception of pregnancy as a normal phenomenon leading to a disregard of the potential associated risks
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
