Perceptions of risk during pregnancy amongst urban women in Northeast Brazil

The aim of the study was to explore the influences on the perceptions of potential risks of pregnancy in a developing country. The perceptions were analyzed in order to construct a local explanatory model of health which could be compared to the activities promoted by the health services. The relationship of perceptions of risk to women's reported motivation for using the health services is assessed. The findings are presented in relation to four specific research questions: 1, How do women view the state of being pregnant? 2, What potential risks are associated with being pregnant? 3, How are these risks explained? 4, What are women's motivations for using prenatal care services? The paper discusses the influence of the local explanatory model on women's perceptions of health risks during pregnancy, the compatibility with the biomedical model and the influence of either on the use of health services by women. In the course of analysing the findings, a number of questions emerged concerning the assumptions often underlying this kind of study. First, the results suggested that seeking one coherent explanatory medical model for local perceptions of risk may not be appropriate. Secondly, different explanations for perceived risks does not necessarily mean a conflict with the activities of the health services. Thirdly, the explanatory model is only part of the influences on women's perceptions of health risks. The socio-economic context of their lives and the structure and practices of the local health system are equally important factors. An approach based on different assumptions which locates individual experiences within the influences of explanatory medical models, the socio-economic circumstances and the structure and practices of the health system provides a better understanding of how perceptions of health risks are formed, how they influence use of the health services and how they change over time.