Mode of birth and social inequalities in health: The effect of maternal education and access to hospital care on cesarean delivery

Kottwitz, Anita

doi:10.1016/j.healthplace.2014.01.005

Cited by 17 publications

(13 citation statements)

References 64 publications

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“…In France, Guihard and Blondel [ 24 ] report that women with a low level of education have a higher risk of cesarean deliveries. German studies point out high rates of surgical deliveries for low-income women [ 25 , 26 ]. Accordingly, Italian mothers with low education levels consistently give birth by a cesarean delivery more often than highly educated women [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

“…Finally, Joseph et al [ 31 ] find that the most affluent Canadian women are less likely to have a cesarean delivery than those in the lowest income category. The existing literature explains the high rates of cesarean deliveries for low-income patients in several ways, including by a greater preference for cesarean deliveries and a low access to obstetric care [ 25 , 30 ]. However, no consensus has been reached on the underlying reasons.…”

Section: Introductionmentioning

confidence: 99%

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Prenatal care and socioeconomic status: effect on cesarean delivery

Milcent¹,

Zbiri

2018

Health Econ Rev

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Cesarean deliveries are widely used in many high- and middle-income countries. This overuse both increases costs and lowers quality of care and is thus a major concern in the healthcare industry. The study first examines the impact of prenatal care utilization on cesarean delivery rates. It then determines whether socioeconomic status affects the use of prenatal care and thereby influences the cesarean delivery decision. Using exclusive French delivery data over the 2008–2014 period, with multilevel logit models, and controlling for relevant patient and hospital characteristics, we show that women who do not participate in prenatal education have an increased probability of a cesarean delivery compared to those who do. The study further indicates that attendance at prenatal education varies according to socioeconomic status. Low socioeconomic women are more likely to have cesarean deliveries and less likely to participate in prenatal education. This result emphasizes the importance of focusing on pregnancy health education, particularly for low-income women, as a potential way to limit unnecessary cesarean deliveries. Future studies would ideally investigate the effect of interventions promoting such as care participation on cesarean delivery rates.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prenatal care and socioeconomic status: effect on cesarean delivery

Milcent¹,

Zbiri

2018

Health Econ Rev

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“…This imbalanced geographical distribution can lead to inefficiency in the offered services and inequalities in access to services (6,7), since the necessity to travel long distances to reach health-care services inhibits patients' use of the services and leads to increases in inequalities in health (8)(9)(10). Accessibility refers to the relative ease of access to a given location (11).…”

Section: Introductionmentioning

confidence: 99%

Spatial accessibility of the population to urban health centres in Kermanshah, Islamic Republic of Iran: a geographic information systems analysis

Reshadat

Saedi

Zangeneh

et al. 2015

Easter Mediterr Health J

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Geographic information systems (GIS) analysis has not been widely used in underdeveloped countries to ensure that vulnerable populations have accessibility to primary health-care services. This study applied GIS methods to analyse the spatial accessibility to urban primary-care centres of the population in Kermanshah city, Islamic Republic of Iran, by age and sex groups. In a descriptive-analytical study over 3 time periods, network analysis, mean centre and standard distance methods were applied using ArcGIS 9.3. The analysis was based on a standard radius of 750 m distance from health centres, walking speed of 1 m/s and desired access time to health centres of 12.5 mins. The proportion of the population with inadequate geographical access to health centres rose from 47.3% in 1997 to 58.4% in 2012. The mean centre and standard distance mapping showed that the spatial distribution of health centres in Kermanshah needed to be adjusted to changes in population distribution. 3. L'analyse reposait sur un rayon standard de 750 mètres de distance à partir des centres de soins, à une vitesse de marche d'un mètre par seconde et un temps d'accès souhaité aux centres de soins de santé de 12,5 minutes. La proportion de la population ayant un accès géographique inadéquat aux centres de soins a augmenté, passant de 47,3 % en 1997 à 58,4 % en 2012. La cartographie de la distance moyenne et standard jusqu'aux centres a révélé que la répartition spatiale des centres de soins de santé à Kermanshah devait être ajustée aux changements dans la répartition de la population. ‫اجلغرافية‬ ‫املعلومات‬ ‫لنظم‬

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“…Women's abilities to argue their cases and seek legal recourse in case of medical complications may act as a more powerful form of pressure on health staff in urban areas (41)(3). (25). The higher levels of human and social capital of women could make it more difficult for health personnel to resist women's requests to undergo CS.…”

Section: Discussionmentioning

confidence: 99%

“…These proximate determinants are in turn determined by distal determinants, such as biomedical factors, but also social, cultural and political characteristics at individual, interindividual and collective levels. These characteristics include women's human, economic and social capital but also cultural beliefs, values and norms regarding family and gender relations (24), interactions between social groups (9), the media and formal institutions, welfare state and national policies as well as economic conditions (3) (25). Due to contrasted modes of socialization and levels of equipment, we expect underlying processes related to these phenomena to differ between rural and urban areas.…”

Section: Literature Review Relationship Between Cs and Place Of Residmentioning

confidence: 99%

Magnitude and Correlates of Caesarean Section in Urban and Rural Areas: A Multivariate Study in Vietnam

Loenzien

Schantz

Luu

et al. 2019

Preprint

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Caesarean section can prevent maternal and neonatal mortality and morbidity. However, it involves risks and high costs which can be a burden, especially in low and middle income countries. The international healthcare community considers the optimal caesarean rate to be between 10% and 15%. The aim of this study is to assess its magnitude and correlates among women of reproductive age in urban and rural areas in Vietnam. We analyzed microdata from the national Multiple Indicator Cluster Survey (MICS) conducted in 2013-2014 using representative sample of households at the national level as well as regarding the urban and the rural areas. A total of 1,378 women who delivered in institutional settings in the two years preceding the survey were included. Frequency and percentage distributions of the variables were performed. Bivariate and multivariate logistic regression analysis were undertaken to identify the factors associated with caesarean section. Odds ratios with 95% confidence interval were used to ascertain the direction and strength of the associations. The overall CS rate among the women who delivered in healthcare facilities in Vietnam is particularly high (29.2%) with regards to WHO standards. After controlling for significant characteristics, living in urban areas more than doubles the likelihood of undergoing a CS (OR = 2.31; 95% CI 1.79 to 2.98). Maternal age at delivery over 35 is a major positive correlate of CS. Beyond this common phenomenon, distinct lines of socioeconomic and demographic cleavage operate in urban versus rural areas. The differences regarding correlates of CS according to the place of residence suggest that specific measures should be taken in each setting to allow women to access childbirth services appropriate to their needs. Further research is needed on this topic.

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Mode of birth and social inequalities in health: The effect of maternal education and access to hospital care on cesarean delivery

Cited by 17 publications

References 64 publications

Prenatal care and socioeconomic status: effect on cesarean delivery

Prenatal care and socioeconomic status: effect on cesarean delivery

Spatial accessibility of the population to urban health centres in Kermanshah, Islamic Republic of Iran: a geographic information systems analysis

Magnitude and Correlates of Caesarean Section in Urban and Rural Areas: A Multivariate Study in Vietnam

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