Delayed pregnancy disclosure, attributed social factors and implications for antenatal care initiation: a qualitative study among Ugandan women and their partners
Outcomes: Sexual and Reproductive Health
View SourceKey Social Norms Take-aways Social norms around pregnancy disclosure—particularly expectations to conceal pregnancy early due to fear of judgement, stigma, and bewitchment—play a critical role in delaying access to antenatal care by limiting women’s ability to mobilize social support when it is most needed.
Objectives This study aimed to understand social norms surrounding pregnancy disclosure among Ugandan women and their partners, and how these norms influence the timing of antenatal care (ANC) initiation.
Methods The study used qualitative methods, conducting semi-structured in-depth interviews with 30 pregnant women and 15 male partners attending their first ANC visit in Kampala, Uganda. Data were analyzed using a combination of deductive and inductive thematic analysis, with a focus on social norms, disclosure practices, and social support dynamics.
Results Women commonly practiced selective and phased disclosure, initially sharing pregnancy information with trusted individuals (e.g., partners or mothers) and delaying broader disclosure until the second trimester or later. Social norms discouraging early disclosure were driven by fears of social judgement (e.g., being too young, in school, or in an unstable or socially unrecognized relationship), as well as beliefs about witchcraft and jealousy causing harm to pregnancies. These norms contributed to delayed access to emotional, informational, and financial support, which in turn delayed ANC initiation. Many women reported that they could not seek care earlier because they had not yet disclosed their pregnancy to those who could assist them.
Conclusions Delayed pregnancy disclosure—shaped by strong social norms and fears of negative social and supernatural consequences—limits women’s access to critical social support and contributes to late ANC initiation. Addressing these norms through stigma reduction, improved community awareness, and strengthening women’s autonomy and support networks is essential for promoting earlier care-seeking and improving maternal and neonatal health outcomes.
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