Pré-natal e parto: diferenças entre as adolescentes e jovens usuárias da saúde suplementar e as do Sistema Único de Saúd

Prenatal care and childbirth: differences between girls and young women receiving private healthcare and through Brazil’s Unifi ed National Health System

Abstract

Objective: To analyze prenatal and childbirth care in Northeast Brazil among girls and young women with private health
insurance and under Brazil’s Unifi ed National Health System. Methods: Cross-sectional study with new mothers between
10 and 24 years old. Hospital-based healthcare facilities in Northeast Brazil. Probability sample, with 3014 new mothers, with data collected from February 2011 to October 2012, using an electronic form. For the bivariate analysis, the Pearson’s
chi-square test was used, measuring effects by the odds ratio through the SPSS software, version 17.0. Results: There were
statistically signifi cant associations between use of private health insurance and age bracket 20-24 years (p<0.001); white
skin (p<0.001); wage-paying job-holder (p<0.001); higher education level (p <0.001), higher economic class (p<0.001);
prenatal care (p=0.023), early-starting prenatal care (p=0.002), at least six visits (p=0.001); delivery in recommended
healthcare facility (p=0.023); wish for C-section towards the end of pregnancy (p<0.001); and responsibility for deciding
on the type of birth not taken by the physician (p=0.022). Conclusion: There were major differences in care during the
prenatal and delivery stages among girls and young women with private medical insurance and under Brazil’s Unifi ed
National Health System in northeast Brazil, in favor of those with private health insurance. Public administrators must invest
in human and material resources that ensure better access to good quality government healthcare for girls and young
women during pregnancy and childbirth