Early Contraception and Continuity of Maternal Health Care in Primiparous Adolescents and Young Adults from Low- and Middle-Income Countries: the Case of Mexico

Introduction We examined the continuum of maternal health care by identifying the relationships among four maternal and reproductive health behaviors in Mexican primiparous adolescents and young adults: using preconceptional contraceptive methods (PreCs), frequently using skilled and timely antenatal-care (ANC) services with adequate contents, using skilled and institutional birth-care services, and using postpartum contraceptive methods (PostCs). Methods We conducted a population-based, and retrospective cross-sectional study using data from the 2018–2019 wave of the National Health and Nutrition Survey on 1,075 primiparous adolescents and young adults between the ages of 10 and 24 years (population N = 1,964,518). After describing the principal sociodemographic and health characteristics of the study population, multiple logistic regression models were run to assess the relationships of interest. This paper reports adjusted odds ratios (aORs) and their 95% confidence intervals (CIs). Results Using PreCs had no impact on the use of skilled, institutional, and timely ANC services nor on the frequency with which patients utilized ANC services with adequate contents. This was not the case with respect to having been provided with a PostC method or having received skilled and institutional birth care together with a PostC method. Additionally, using skilled, institutional, and timely ANC services was associated only with a greater likelihood of frequently using ANC services with adequate contents. However, the figures were lower for younger and indigenous women, beneficiaries of conditional cash transfers through the Prospera public program, and women of higher socioeconomic levels. Using PostCs was correlated with being covered by the government health-insurance scheme ( Seguro Popular ), frequently using ANC services, giving birth in a Social Security facility, participating in the Prospera program, and residing in a municipality marked by low levels of social marginalization. Conclusions The findings of this study contribute to identifying linkages in the use of services along the continuum of maternal health care. Strong associations exist within, but none between, the maternal and reproductive health services. Special attention must be devoted to those population groups that have repeatedly shown a suboptimal use of services throughout the different stages of the maternal care continuum.