Access to childbirth care by adolescents and young people in the Northeastern region of Brazil

Abstract

OBJECTIVE To identify the factors that interfere with the access of adolescents and young people to childbirth care for in the Northeast region of Brazil.METHODS Cross-sectional study with 3,014 adolescents and young people admitted to the selected maternity wards to give birth in the Northeast region of Brazil. The sample design was probabilistic, in two stages: the first corresponded to the health establishments and the second to women who had recently given birth and their babies. The data was collected by means of interviews and consulting the hospital records, from pre-tested electronic form. Descriptive statistics were used for the univariate analysis, Pearson’s Chi-square test for the bivariate analysis and multiple logistic regressions for the multivariate analysis. Sociodemographic variables, obstetrical history, and birth care were analyzed.RESULTS Half of the adolescents and young people interviewed had not been given guidance on the location that they should go to when in labor, and among those who had, 23.5% did not give birth in the indicated health service. Furthermore, one third (33.3%) had to travel in search of assisted birth, and the majority (66.7%) of the postpartum women came to maternity by their own means. In the bivariate analysis, the variables marital status, paid work, health insurance, number of previous pregnancies, parity, city location, and type of health establishment showed a significant association (p < 0.20) with inadequate access to childbirth care. The multivariate analysis showed that married adolescents and young people (p < 0.015), with no health insurance (p < 0.002) and from the countryside (p < 0.001) were more likely to have inadequate access to childbirth care.CONCLUSIONS Adolescents and young women, married, without health insurance, and from the countryside are more likely to have inadequate access to birth care. The articulation between outpatient care and birth care can improve this access and, consequently, minimize the maternal and fetal risks that arise from a lack of systematic hospitalization planning.

Fatores associados à variação espacial da gravidez na adolescência no Brasil, 2014: estudo ecológico de agregados espaciais

“…number of prenatal care sessions can be attributed in part to difficulties in making appointments at health services and the peregrination undertaken by pregnant women in order to get access to childbirth facilities. 29 Unequal distribution of socioeconomic, demographic and health care factors in determining spatial variation of the adolescent fertility rate was evident in its relationship with the Gini index, an indicator of social inequality, in keeping with results of studies covering smaller areas. 3,5,13,30 Positive association between the fertility rate and the proportion of adolescent mothers with low schooling reinforces the role of this indicator as a proxy for precarious socioeconomic conditions.…”

Age of first pregnancy in Brazil: data from the national health survey

“…This finding may be related to the failure of marital status in this age group, showing the marriage increasingly early. Furtado et al 29 found in research on childbirth care of young people in the Northeast region of Brazil, 77.6% of participants between 12 and 24 years reported having marital ties, as well as education to primary education (54.6%) and belonging to lower economic classes (50.7%).…”

Experiência da gravidez entre adolescentes gestantes

“…15 In regard to the scenario in which developed the study, believes that this region is one of the poorer areas of the country and its inhabitants declare more difficulties to access health services, which may explain the pregnancy in adolescence and the precarious socioeconomic conditions. 16 It was evident that no adolescent pregnant woman wielded remunerated activity; all that occupied the attention of the house and financially dependent on the partner or the family. Similar findings with research carried out with 12 adolescents who lived in Cuiabá, Mato Grosso, and Southern Region of Brazil.…”