The unbooked maternity patient in an academic hospital in Durban

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.