BACKGROUND:
In 2020, almost 95% of all maternal deaths occurred in low and lower-middle-income countries (LMICs). Lack of information-sharing between facilities and inadequate protocols were causes of delays in emergency care and management, leading to maternal deaths. Women may face challenges in accessing healthcare facilities due to geographical barriers, financial issues, lack of transportation, or limited availability of healthcare services in rural areas. Cultural restrictions on leaving the home, unfavourable weather conditions, distance to health facilities, negative experiences with healthcare, maternal weakness after childbirth, and transportation costs all hampered care seeking.

OBJECTIVES:
To undertake a systematic review of the literature to date regarding women’s experiences in seeking care during pregnancy and birth, which focuses on the factors influencing women's decisions on birthplaces and caregivers during childbirth in LMICs.

METHODS:
Electronic databases were systematically searched: EMBASE, Medline, MIDIRS, CINAHL, PsycINFO, and WoS from 2012 to 2023. These qualitative studies were original research studies published in peer-reviewed journals in English.

RESULTS:
The overarching themes highlighted in this review demonstrate that women's decisions to seek care during childbirth occur on numerous levels, within and outside the woman’s choice such as partner, family member and community. The following themes: financial factors, travel and transportation, sociocultural factors, and quality of care. Most of the existing evidence on factors influencing care-seeking has focused on barriers, while limited research has studied elements that encourage care-seeking behaviour.

CONCLUSIONS:
a). Female family members were major decision-makers in LMICs. b). Delays in seeking care were caused by the expense of transport and maternal costs. c). Some LMICs women prefer to give birth at home with TBAs or relatives who understand the norms and practices associated with childbirth in their cultures.

KEY MESSAGE:
Independent decision-making reflects empowerment, where women can independently choose birth settings, companions, and ANC. Financial barriers significantly delay care-seeking and cultural norms shape birth preferences. Poster session 4 (Group B)