title: 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.
authors.affiliation: Hospital Universitário, Universidade Federal do Piauí, Teresina, PI, Brasil.
authors.forename: Érida Zoé Lustosa
authors.initials: ÉZ
authors.lastname: Furtado
authors.affiliation: Centro de Ciências da Saúde, Universidade Federal do Piauí, Teresina, PI, Brasil.
authors.forename: Keila Rejane Oliveira
authors.initials: KR
authors.lastname: Gomes
authors.affiliation: Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.
authors.forename: Silvana Granado Nogueira
authors.initials: SG
authors.lastname: da Gama
mesh_terms: D000293:Adolescent; D000328:Adult; D016550:Birthing Centers; D001938:Brazil; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D000069576:Health Equity; D006297:Health Services Accessibility; D006801:Humans; D008880:Midwifery / Q000706:statistics & numerical data*; D009313:National Health Programs; D011247:Pregnancy; D011253:Pregnancy in Adolescence; D012959:Socioeconomic Factors; D055815:Young Adult