In Mexico, disparities in cesarean births

The April issue of Health Affairs includes an analysis of cesarean birth rates in Mexico, the country in the Americas with the second-highest prevalence of cesarean deliveries (second only to Brazil).

Sylvia Guendelman of the University of California, Berkeley, and coauthors used 2014 Mexican birth certificate data to perform population-level data analyses on more than 600,000 first-time mothers.

According to the authors, 48.7 percent of these births were cesarean deliveries. Individual Mexican states' rates ranged widely but presented no clear geographical patterns (see the exhibit below).

The study also revealed that enrollees in Seguro Popular, the public health insurance program, had lower cesarean birth rates than those in other insurance programs and those without insurance.

The widest difference, however, was in the delivery location: cesarean rates in private birthing facilities occurred almost twice as often as those taking place in other facilities.

"Mexico's continuing transition toward universal health coverage through Seguro Popular...may help curb the cesarean epidemic," the authors conclude. "To do this, the health care system must tackle access barriers to public hospitals..., increase the number of qualified staff members to oversee and support women through the labor process, and educate women about the benefits of vaginal birth."