Understanding ‘late bookers’ and their social circumstances

<jats:p> Little is known about the social context behind women's experiences concerning booking and antenatal care. In this study, women's narratives revealed that reasons for booking late are varied and sometimes complex. Personal non-acceptance of pregnancy, demanding social circumstances and supply-side circumstances such as administrative delays and inefficient communications are contributing factors. Some women booking late found that, once booked, little effort was made to actively retain contact. Other women reported lack of continuity of carer, language and communication issues as well as judgmental attitudes. Overall trust of the service was influenced by hospital reputation, previous experiences and staff behaviours. Disappointment was resolved by seeking care elsewhere in the subsequent pregnancy. It was concluded that maternity services should use late booking as a signal for tailored attention. Services need to be flexible and engaging and alternative communication strategies such as text messaging and use of email employed to inform women about timely booking. </jats:p>