"This study has explored why some women presenting in labour wards with unknown HIV status do not receive HTC at an ANC or do not accept HTC either during or after labour. Several contributing factors were found. The main system-related barriers to getting tested during pregnancy are a lack of available resources and not being offered a test. Mothers’ denial or fear of stigma may prevent them from accessing treatment and care and, as a result, compromise their own health and their children’s when they do not receive preventative treatment to reduce the risk of MTCT. It is essential to understand the dynamics and cultural boundaries that limit women’s access to testing as a gateway to PMTCT care."