Factors associated with low adherence to postpartum consultation: a cross-sectional study

TL;DR

This study explores why many postpartum women in a Brazilian municipality skip follow-up consultations, finding that lack of time and inadequate prenatal guidance are key factors.

Contribution

The study identifies specific factors associated with low adherence to postpartum consultations in a specific regional context.

Findings

67% of women attended postpartum consultations, indicating a significant non-adherence rate.

Women who received prenatal care at Basic Health Units were less likely to attend postpartum consultations.

Lack of guidance during prenatal care about postpartum follow-up was strongly associated with non-attendance.

Abstract

One of the attributes that attest to the effectiveness of postpartum care is the longitudinality of health care, which must be offered by Primary Health Care, an entity responsible for offering support and attention to maternal demands or women's health conditions.

To investigate the frequency of postpartum consultations and the factors associated with low adherence to follow-up among postpartum women living in a municipality in the interior of the Northeast.

Cross-sectional study, developed in the urban area of the municipality of Senhor do Bonfim, Bahia, Brazil, between June 2019 and January 2020. 97 women were surveyed, based on semi-structured interviews. The Chi-square/Fisher's Exact and Multiple Logistic Regression tests were used to perform data analysis.

There was 67% attendance at the postpartum consultation. Furthermore, an association was found between not having attended a postpartum consultation and the following variables: having attended prenatal care at the Basic Health Unit (OR: 0.08; p=0.002) and not having received guidance during prenatal care about the importance of returning for postpartum follow-up (OR: 0.22; p=0.004).

It is important to highlight that even with the existence of national protocols, states and municipalities can implement measures to improve postpartum care based on their respective realities.

A low frequency of postpartum consultations was observed among the women surveyed, and the main reason for non-attendance was the difficulty in going to the consultation due to lack of time. In addition, the lack of continuity of care after childbirth among women who attended prenatal care at the SUS stands out.