Equality in health and health care during pregnancy. A prospective population-based study from southern Sweden

To study health and health care during pregnancy for manual workers compared with non-manual employees.

A prospective population-based study of all women who were registered for antenatal care during 1986 in the catchment areas of three health centers.

Three district antenatal clinics in southern Sweden.

409 pregnant women; of whom 403 with singleton pregnancies; of whom 185 were manual workers and 175 were non-manual employees.

Problems encountered (registered according to the international classification of diseases) and measures taken.

The study population resembled all women who gave birth in Sweden during the same year. Both manual workers and non-manual employees registered for antenatal care in early pregnancy (96% and 97%, respectively, before 15 completed weeks). The women in both groups made the same number of visits to the antenatal clinics (median 12 and 13, respectively). There were no differences between the two groups of women as regards the percentage figures for obstetric problems encountered during pregnancy. The manual workers had a higher frequency of diseases of the musculoskeletal system (mainly low-back pain) compared with the non-manual employees (RR = 1.89; 95% CI = 1.20-2.98), and they were sicklisted more often (RR = 1.21; 95% CI = 1.01-1.46). On the other hand, their frequency of amniocentesis was lower (RR = 0.39; 95% CI = 0.19-0.80); the reason for this was that the manual workers were younger than the non-manual employees. Otherwise, there were no differences between the two groups of women as regards the percentage figures, either for non-obstetric problems encountered, or measures taken, or regarding the outcome of pregnancy.

In Sweden, both manual and non-manual working women appear to enjoy equal antenatal health and receive equal antenatal care. This conclusion is based on a small study population, meticulously monitored prospectively throughout pregnancy.