Inequities in access to maternal health care: a look with a gender perspective

Gender and health inequities, such as violence during pregnancy and lack of access to health care, put women at risk when they seek help in their communities and must be transferred to hospitals. The reasons why this happens can be studied under the three delays model, which im-plies the time required to a) make a decision to seek care, b) access a place to get it, and c) ob-tain the required medical attention. The objec-tive of this study was to describe gender and health care access inequities observed in the maternal care process for women in rural co-mmunities of Yucatan, Mexico. A descriptive, re-trospective, cross-sectional study was caried out. 247 pregnant women were interviewed, of which 29.2 % presented the first delay, 17.8 % the second and 53.0 % the third. 421 obstacles were referred to as barriers that led to delays. The highest percentage of obstacles (253) co-rresponded to the third delay, where inadequate and untimely medical treatment, and the lack of medical criteria for admission played a promi-nent role (52.7 % and 43.5 %, respectively). The first and second delay registered morbidity in-cidences of 61.1 % and 59.1 %, respectively. The incidence of the third was 76.3 % and was sig-nificantly (P < 0.05) higher than the other two. Economic violence was present in 53 % of the cases. The reorganization of the maternal heal-th system is essential to reduce the barriers that cause delays in health care, specially the third delay, which is related to the quality of care.