From therapeutic to elective cesarean deliveries: factors associated with the increase in cesarean deliveries in Chiapas

Abstract

BackgroundCesarean deliveries have increased over the past decade in Mexico, including those states with high percentages of indigenous language speakers, e.g., Chiapas. However, the factors contributing to this trend and whether they affect indigenous languages populations remain unknown. Thus, this work aims to identify some of the factors controlling the prevalence of cesarean sections (C-sections) in Chiapas between the 2011–2014 period.MethodsWe analyzed certified birth data, compiled by the Subsystem of Information on Births of the Secretary of Health and the National Institute of Statistics and Geography, and information regarding the Human Development Index (HDI), assembled by the United Nations Development Program. A descriptive analysis of the variables and a multilevel logistics regression model were employed to assess the role of the different factors in the observed trends.ResultsThe results show that the factors contributing to the increased risk of C-sections are (i) women residing in municipalities with indigenous population and municipalities with high HDIs, (ii) advanced schooling, (iii) frequent prenatal checkups, and (iv) deliveries occurring in private health clinics. Furthermore, C-sections might also be associated with prolonged hospital stays.ConclusionsThe increasing frequency of C-sections among indigenous populations in Chiapas seems to be related to public policies aimed at reducing maternal mortality in Mexico. Therefore, public health policy needs to be revisited to ensure that reproductive rights are being respected.

Trends of caesarean delivery from 2008 to 2017, Mexico

“…While higher socioeconomic status has been associated with an increase in caesarean delivery, 22 , 23 vulnerable populations, such as indigenous groups, are also at risk of unnecessary caesarean delivery and should be monitored when assessing the effect of policies on caesarean delivery 23 . Unfortunately, vulnerable populations who had access to health care through Mexico’s universal health-care insurance, Seguro Popular, might again be at risk, given current attempts to abolish it 24 .…”

Assessment of diagnostics capacity in hospitals providing surgical care in two Latin American states

“…In Chiapas, with a population of about 5.3 million, more than 80% of residents were enrolled in the government-funded Seguro Popular [12] . Despite a significant proportion of the population with public insurance, healthcare is delivered in both public and private hospitals [ 15 , 16 ]. In Brazil, the government's health scheme, Sistema Único de Saúde (SUS), is one of the largest public health care systems in the world, aiming to provide universal health coverage to all Brazilians [17] .…”

“…[45,46] 21.0 21.4 Female life expectancy [45,46] 76.2 79.2 Fertility rate [45,46] 3.1 1.9 Indigenous population in the state (%) [11,47] 36.2 4.8 *Healthcare Access and Quality Index [45,46] 55.8 60.4 **Human Development Index (2010) [48,49] 0.656 0.674 GDP per capita in the state (nation) in USD [45,46] 10,311 (16,829) 11,917 (13,759) Educational attainment in the state (nation) in years [45,46] 6. enrolled in the government-funded Seguro Popular [12]. Despite a significant proportion of the population with public insurance, healthcare is delivered in both public and private hospitals [15,16]. In Brazil, the government's health scheme, Sistema Unico de Sa ude (SUS), is one of the largest public health care systems in the world, aiming to provide universal health coverage to all Brazilians [17].…”

Maintaining the Flow: Medical Challenges to Breastfeeding and “Risky” Bodies in Mexico

“…While the high level of emergency transfers and 36.2% caesarean section rate in public hospitals (Freyermuth et al. ) undoubtedly shape doctors’ attitudes about the risks associated with childbearing and the health profile of poor women, they do not necessarily reflect how pregnancy, birth, and early nurturing is happening across the city landscape.…”