Adequação do uso de pílula anticoncepcional entre mulheres unidas

A total of 2,364 women in marital union, 15 to 49 years of age, were interviewed at home. They lived in poor neighbourhoods in the metropolitan area and in the interior of S. Paulo State, Brazil. The prevalence of contraceptive pill use and the association between socio-demographic characteristics of users and the presence or not of risk factors for pill use were studied. One fourth (25.8 percent) of the women interviewed were using contraceptive pills. Prevalence was higher among younger women, those with no more than one live child and those who had completed between three and eight grades of schooling. Over 40 percent of the users referred having risk factors for pill use at the time they initiated the method. No association was found between age and the percentage of women with risk factors. This percentage increased with number of children and decreased with women's schooling. The fact that pills were prescribed or obtained through the health system was not associated with the proportion of users with risk factors. The percentage of users with risk factors was similar when comparing women who did not consult any health service before initiating use with those who had consulted a public service. The prevalence of use observed in this study is similar to that described by other authors. Results show that the health system in the State of S. Paulo played no role in the improvement in the prescription of hormonal contraceptive pills. Central policy seemed not to have filtered down to the peripheral areas of the system.Foram entrevistadas em seus domicílios 2.364 mulheres unidas de 15 a 49 anos de idade, que moravam em bairros de baixa renda, na área metropolitana e no interior do Estado de São Paulo, Brasil. Estudou-se a prevalência de uso da pílula contraceptiva, a associação entre algumas características sócio-demográficas das usuárias e a presença ou não de fatores de risco para seu uso. Verificou-se que 25,8% das mulheres usavam pílula anticoncepcional. A prevalência de uso foi maior entre as mais jovens, entre as com até um filho vivo e nas com 5ª a 8ª séries de escolaridade. Mais de 40% das usuárias referiram apresentar fatores de risco ao iniciar o uso. Não se verificou associação entre a idade e a percentagem de mulheres com fatores de risco. Essa percentagem aumentou com o número de filhos e diminuiu com a escolaridade da mulher. A presença de fatores de risco foi igualmente freqüente entre as mulheres que não consultaram nenhum serviço de saúde para iniciar o uso como entre aquelas que consultaram em serviços públicos. As políticas do nível central não parecem ter atingido a periferia do sistema