title: Inadequate use of prenatal services among Brazilian women: the role of maternal characteristics.
abstract: BACKGROUND
  To improve the uptake of prenatal care, it is important to know how the use of prenatal care varies by maternal attitudes and social and demographic factors.
  
  
  METHODS
  Information about social and demographic variables, prenatal care, parity, pregnancy planning, abortion attempts, satisfaction with pregnancy and satisfaction with the relationship with the child's father was collected from 611 postpartum women in Porto Alegre in southern Brazil. Multinomial logistic regression was used to evaluate associations between these variables and whether the women's use of prenatal care was adequate, partially inadequate or inadequate.
  
  
  RESULTS
  About 40% of women had inadequate or partially inadequate prenatal care. After adjustment for other covariates, including satisfaction with the pregnancy, women having an unplanned pregnancy were significantly more likely to have had inadequate care than women who had planned their pregnancy (odds ratio, 2.0). Not living with the child's father (2.8) and dissatisfaction with pregnancy (2.1) were also associated with inadequate use of prenatal care. Women having their second or higher order birth were significantly more likely to report inadequate use of prenatal care than women having their first birth (3.9-9.0). Household income was inversely associated with inadequate use of care.
  
  
  CONCLUSIONS
  The study suggests that maternal attitudes may be important for adequate prenatal care. Interventions should be created to encourage women with negative maternal attitudes to use prenatal care and to ensure that they have access to the care they need.
authors.affiliation: Centre for Global Health Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario.
authors.forename: Diego G
authors.initials: DG
authors.lastname: Bassani
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Surkan
authors.forename: Maria Teresa A
authors.initials: MT
authors.lastname: Olinto
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001938:Brazil; D002648:Child; D016001:Confidence Intervals; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008429:Maternal Welfare; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D055815:Young Adult