[Factors associated with a lack of postnatal care].

BACKGROUND

Postnatal care is essential to identify and treat at the appropriate time adverse health events in the puerperium. In Mexico, the factors that affect postnatal care have not been documented.

OBJECTIVE

To identify the factors associated with the lack of postnatal care.

MATERIAL AND METHODS

Cross-sectional study of 202 women of reproductive age affiliated with six primary care clinics of the Mexican Institute for Social Security. We analyzed these factors: (1) sociodemographic: age, education, schooling, distance between home and clinic; (2) psychosocial: social support; (3) obstetric and gynecologic: number of pregnancies, type of delivery, presence of comorbidity and suspected depression, and (4) health services: deficient prenatal control and incomplete postpartum hospital care. We performed multiple Poisson regression with a robust variance.

RESULTS

49.5% of women had postnatal control. Factors associated with a higher probability of lack of postnatal control were: distance ≥ 5 km between home and clinic (adjusted prevalence ratio [aPR] 1.48, 95% confidence interval [95% CI] 1.16-1.88, p = 0.001), poor prenatal care (aPR 1.21, 95% CI 1.001-1.46, p = 0.049), and incomplete postpartum care (aPR 1.42, 95% CI 1.23-1.63, p < 0.001).

CONCLUSIONS

The low attendance of postnatal care in primary care clinics highlights the need to seek and implement feasible healthcare alternatives, such as home care or telemedicine, to women who cannot attend to postnatal consultations.