Introduction: Studies on attitudes and practices are increasingly used but not specifically related to the motivations for the use of reproductive health care among women of fertile age, living in urban areas and in different social contexts. Objectives: The aim of this study was to estimate the associations between the variables of social status (degree of poverty in the studied groups) and the variables of fecundity (representations, tensions, practices and control of fertility) and, in addition, to compare access to health care in the different studied groups, assessing the association between use of maternal health care and poverty in urban areas. Design: A case-control study was conducted in the Municipality of Lisbon, Portugal, with a total sample of 1513 women of fertile age: 499 cases of women considered very poor were selected from the database of beneficiaries of RSI (Social Welfare Payment for Inclusion); 1014 controls (two controls for each selected case), divided as 507 poor women selected from the other beneficiaries of Santa Casa da Misericórdia in Lisbon and 507 non-poor women selected from four Health Centers from the Municipality of Lisbon, Portugal. A total of 1054 women answered the questionnaire: 304 cases (response rate of 61%) and 750 (response rate of 74%) controls. The statistical analysis involved descriptive analysis and multinomial logistic regression. Results: The analysis confirms the association between poverty and patterns and representations of fecun
dity regarding pregnancy planning.The results of this study thus show the existence of different distributions on several variables and the gradients of poverty. Regarding access to health care, the major impact of poverty on women
Braveman, P. (2007) We also need bold experiments: A response to Starfield’s “Commentary: Pathways of influence on equity in health”. Social Science and Medicine, 64, 1363-1366. http://dx.doi.org/10.1016/j.socscimed.2006.11.028
Whitehead, M. and Dahlgren, G. (2007) Concepts and principles for tackling social inequities in health: Leveling up part 1. Studies on social and economic determinants of population health, No 2. WHO Regional Office for Europe, Copenhagen. http://www.euro.who.int/document/e89383.pdf
Sunil, T.S., Spears, D.W., Hook, L., Castillo, J. and Torres, C. (2008) Initiation of and barriers to prenatal care use among low-income women in San Antonio, Texas. Maternal and Child Health Journal, 14, 133-140. http://dx.doi.org/10.1007/s10995-008-0419-0
Mendonca, D. and Calado, B.P. (2002) Situacao da saúde reprodutiva em Portugal. In: Craveiro, I. and Ferrinho, P., Eds., Saúde reprodutiva no países e territórios de língua Portuguesa. Associacao para o Desenvolvimento e Cooperacao Garcia de Orta (AGO), Lisboa.
Comission of the European Communities (2008) Nondiscrimination and equal opportunities: A renewed commitment-COM 420, Commission staff working document Community, Instruments and Policies for Roma Inclusion, Brussels.
Whitehead, M., Dahlgren, G. and Evans, T. (2001) Equity and health sector reforms: Can low income countries escape the medical poverty trap? Lancet, 358, 833-836. http://dx.doi.org/10.1016/S0140-6736(01)05975-X
Limwattananon, S., Tangcharoensathien, V. and Prakongsai, P. (2007) Catastrophic and poverty impacts of health payments: results from national household surveys in Thailand. Bulletin of the World Health Organization, 85, 600-606. http://dx.doi.org/10.2471/BLT.06.033720
Wagstaff, A. and Waters, H. (2005) How were the reaching the poor studies done? In: Gwatkin, D., Wagstaff, A. and Yazbeck, A., Eds., Reaching the poor—With health, nutrition and population services, what works, what doesn’t, and why. The World Bank, Washington DC.