Paradox lost on the U.S.-Mexico border: U.S. Latinas and cesarean rates

Theresa Morris,Christine H Morton,Amanda Gomez,Miriam Naiman-Sessions

doi:10.1186/s12884-018-1701-9

Theresa Morris, Christine H Morton + Show 2 more

Open Access

https://doi.org/10.1186/s12884-018-1701-9

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Abstract

BackgroundWe apply Intersectional Theory to examine how compounded disadvantage affects the odds of women having a cesarean in U.S.-Mexico border hospitals and in non-border hospitals. We define U.S. Latinas with compounded disadvantage as those who have neither a college education nor private health insurance.ResultsAnalyzing quantitative and qualitative data from Childbirth Connection’s Listening to Mothers III Survey, we find that, consistent with the notion of the Latinx Health Paradox, compounded disadvantage serves as a protective buffer and decreases the odds of cesarean among women in non-border hospitals. However, the Latinx Health Paradox is absent on the border.ConclusionOur data show that women with compounded disadvantage who give birth on the border have significantly higher odds of a cesarean compared to women without such disadvantage. Further, women with compounded disadvantage who give birth in border hospitals report receiving insufficient prenatal, pregnancy, and postpartum information, providing a direction for future research to explain the border disparity in cesareans.

Highlights

We apply Intersectional Theory to examine how compounded disadvantage affects the odds of women having a cesarean in U.S.-Mexico border hospitals and in non-border hospitals
Our study focuses on the United States border region (i. e. 100 km north of the U.S Mexico border)
Sixty-nine percent of women in the non-border region had private health insurance compared to 56.9% of women in the border

Summary

Introduction

We apply Intersectional Theory to examine how compounded disadvantage affects the odds of women having a cesarean in U.S.-Mexico border hospitals and in non-border hospitals. Border residents have a lower level of educational attainment than the general population and are less likely to have private health insurance, despite Latinos’ and Latinas’ lower socioeconomic status, Latinx ethnicity in the United States is often correlated with positive health outcomes – a phenomenon referred to as the Hispanic or Latinx Health Paradox [3]2. This phenomenon has been applied to maternal-fetal health, findings typically focus on fetal rather than maternal outcomes. Studies have found that Latinas have lower pre-term birth, low-birth weight, and maternal mortality rates compared to non-Latinas in the U.S [4,5,6,7,8,9]

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