Maternal decision on obtaining prenatal care: a study in Brazil.
OBJECTIVE
to address the social aspects of pregnancy and the views of pregnant women regarding prenatal assistance in Brazil.


METHODS
this qualitative study was focused on describing the Social Representations of prenatal care held by pregnant women. The discourse of the collective subject (DCS) framework was used to analyse the data collected, within the theoretical background of social representations, as proposed and developed by Serge Moscovici.


METHODS
21 pregnant women who were users of the publicly funded Brazilian unified health-care system and resided in the area served by its family health programme in a low- to middle-income neighbourhood on the outskirts of Campo Grande, the capital of the state of Mato Grosso do Sul, in southwestern Brazil. Data were collected by conducting in-depth, face-to-face interviews from January to October 2006.


RESULTS
all participants were married. Formal education of the participants was less than five years in four cases, between five and eight years in six cases, and greater than 11 years in 10 cases. Nine participants had informal jobs and earned up to US$ 200 per month, four participants had administrative jobs and earned over US$ 500 per month, and eight participants did not work. No specific racial/ethnic background predominated. Lack of adherence to prenatal care allowed for the identification of two DCS themes: 'organisation of prenatal care services' and 'lifestyle features'.


CONCLUSIONS
the respondents were found to have negative feelings about pregnancy which manifest as many fears, including the fear of harming their children's health, of being punished during labour, and of being reprimanded by health-care professionals for overlooking their prenatal care, in addition to the insecurity felt towards the infant and self.


CONCLUSIONS
the findings reveal that communication between pregnant women and health-care professionals has been ineffective and that prenatal care has not been effective for the group interviewed--features that are likely to be found among other low- to middle-income groups living elsewhere in Brazil.
Duarte
Sebastião Junior Henrique
SJ
Federal University of Mato Grosso, Rua José da Silva Monteiro 168, Cuiabá, MT, Brazil. sjhd@usp.br
de Andrade
Sônia Maria Oliveira
SM
Mamede
Marli Villela
MV
D001291:Attitude of Health Personnel; D001938:Brazil; D005260:Female; D006297:Health Services Accessibility / Q000592:standards; D006301:Health Services Needs and Demand; D054625:Healthcare Disparities; D006801:Humans; D008429:Maternal Welfare / Q000523:psychology*; D011203:Poverty / Q000523:psychology; D011247:Pregnancy; D011295:Prenatal Care / Q000523:psychology / Q000592:standards; D011369:Professional-Patient Relations; D016312:Treatment Refusal / Q000523:psychology*