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.
Highlights
Cesarean deliveries have increased over the past decade in Mexico, including those states with high percentages of indigenous language speakers, e.g., Chiapas
We identified some of the factors associated with the increased numbers of C-sections in Chiapas, Mexico
The study considered women who reside in municipalities with indigenous populations and municipalities with higher Human Development Index (HDI), and among educated women and those undergoing regular prenatal checkups
Summary
Cesarean deliveries have increased over the past decade in Mexico, including those states with high percentages of indigenous language speakers, e.g., Chiapas. Whitridge Williams declared, “the excellence of an obstetrician should be gauged not by the number of cesareans which he performs, but rather by those he does not do.” In the 1980s, health professionals believed that the rate of cesarean deliveries should be 10–15% [1]. Throughout Mexico, there has been a significant increase in the percentage of cesarean deliveries, even in states with high percentages of speakers of indigenous languages (SILs), such as Chiapas (Fig. 1). According to a National Survey of Health and Nutrition comparative analysis, undertaken in 2000, 2006, and 2012, the number of C-sections performed in Mexico increased by 50% over a 12-year period, associated to an increase of 33% and 66% in the public and private sectors, respectively [10]. The Mexican state of Chiapas has experienced a gradual increase in the proportion of the population having medical insurance
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