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Servan-Mori Find articles by Edson E.
Servan-Mori Veronika J. Wirtz Find articles by Veronika J. Received Feb 14; Accepted Jul This article has been cited by other articles in PMC. Abstract Objective To identify the current clinical, socio-demographic and obstetric factors associated with the various types of delivery strategies in Mexico.
Delivery types discussed in this paper include vaginal delivery, emergency cesarean section and planned cesarean section.
Using bivariate analyses, sub-population group differences were identified. Logistic regression models were applied, including both binary and multinomial outcome variables from the survey.
The logistic regression results identify those covariates associated with the type of delivery. Results The highest rates of this procedure were among women who reported a complication during delivery OR: 4.
Conclusions The existence of different socio-demographic and obstetric profiles among women who receive care for vaginal or cesarean delivery, are supported by the findings of the present study. The frequency of vaginal delivery is higher in indigenous women, when the care provider is public and, in women with two or more children at time of the most recent child birth.
Planned cesarean deliveries are positively associated with years of schooling, a higher socioeconomic level, and higher age. The occurrence of emergency cesarean sections is elevated in women with a diagnosis of a health issue during pregnancy or delivery, and it is reduced in highly marginalized settings.
Introduction There are many factors that contribute to the decision to deliver either vaginally or through a cesarean section in a health facility. According to the conceptual framework proposed by Freitas  , these levels include the individual socio-demographic and cultural characteristics of the woman, her obstetric and prenatal care history, her preferences, as well as the circumstances at the time of admission to a facility and throughout the delivery process.
Factors within the facility are staff member training and general facility characteristics  , .
In recent decades, the number of deliveries within health care facilities in Mexico has increased, from During the same time period, the percentage of pregnancies ending in a cesarean section delivery has risen markedly .
This trend is present in both private and public health facilities across the country. Mexico has one of the highest cesarean delivery rates internationally  — .
The trend of increasing reliance on cesarean sections is not exclusive to Mexico, rather, it is a global public health issue especially relevant to low and middle income countries with low health budgets compared to high income countries  — . Concern about the overreliance on cesarean section is based on, first, the association between the procedure and both maternal and fetal medical complications and second, the higher expenditure which does not result in better health outcomes .
Cesarean sections are associated with increased neonatal mortality OR: 1.
Beyond the health complications for the infant, cesarean sections are also associated with increased maternal morbidity and mortality as well as posing a risk for complications in future pregnancies OR: 2. The financial burden of cesarean sections on the health system is high, with greater utilization of medical personnel resources related to the surgical procedure compared to a vaginal delivery .
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