Birth In Mexico Research Articles

Physical environment and life expectancy at birth in Mexico: an eco-epidemiological study

The objective of this ecological study was to ascertain the effects of physical environment on life expectancy at birth, using data from all 32 Mexican states. 50 environmental indicators with information about demography, housing, poverty, water, soils, biodiversity, forestry resources, and residues were included in exploratory factor analysis. Four factors were extracted: population vulnerability/susceptibility, and biodiversity (FC1), urbanization, industrialization, and environmental sustainability (FC2), ecological resilience (FC3), and free-plague environments (FC4). Using OLS regressions, FC2, FC3, and FC4 were found to be positively associated with life expectancy at birth, while FC1 was negatively associated. This study suggests that physical environment is an important macro-determinant of the health of the Mexican population, and highlights the usefulness of ecological concepts in epidemiological studies.

An examination of cesarean and vaginal birth histories among Hispanic women entering prenatal care in two California counties with large immigrant populations.

Repeat cesarean delivery (CD) rates among US Hispanic women are the highest of all racial/ethnic groups (90%). Vaginal birth after cesarean (VBAC) is an alternative delivery method, but requires medical records documentation of a non-vertical incision and favorable conditions in the current pregnancy. VBAC rates for Hispanic women are extremely low. This study explores the birth histories and medical records access among Hispanic women in California, taking into account the potential role of immigration on access to VBAC. Study aims are to describe for a sample of Hispanic women: (1) CD and VBAC histories as well as history of vaginal delivery preceding CD; and (2) medical records access, among women who had previous births in Mexico. Chart review was conducted for prenatal patients from three safety net clinics in two California counties with large Mexican migrant populations between August, 2003 and February 2004—during which VBAC was widely available in these two counties to determine: obstetric histories, CD details, birthplace and whether or not medical records had been requested/obtained for CD. 355 multiparous Hispanic women were included. Thirty-three percent had a previous CD, almost two-thirds (64%) had only one CD. Over half of the women (55%) with 2+ births and CD history also reported a vaginal birth history. Medical records for CD were infrequently requested (29%). Of those requested, records were received for 77% of women with a US CD, compared with 13% of women with Mexican CD histories. Policies to address: (1) VBAC opportunities for low risk women, such as those with prior vaginal births and one CD, and (2) overcoming limited medical records access, could mitigate against unnecessary CD and associated medical expenditures and risks for future complications.

Individual, Household, and Community U.S. Migration Experience and Infant Mortality in Rural and Urban Mexico.

This study explores rural and urban differences in the relationship between U.S. migration experience measured at the individual, household, and community levels and individual-level infant mortality outcomes in a national sample of recent births in Mexico. Using 2000 Mexican Census data and multi-level regression models, we find that women's own U.S. migration experience is associated with lower odds of infant mortality in both rural and urban Mexico, possibly reflecting a process of healthy migrant selectivity. Household migration has mixed blessings for infant health in rural places: remittances are beneficial for infant survival, but recent out-migration is disruptive. Recent community-level migration experience is not significantly associated with infant mortality overall, although in rural places, there is some evidence that higher levels of community migration are associated with lower infant mortality. Household- and community-level migration have no relationship with infant mortality in urban places. Thus, international migration is associated with infant outcomes in Mexico in fairly complex ways, and the relationships are expressed most profoundly in rural areas of Mexico.

Educating Skilled Birth Attendants in Mexico: Do the Curricula Meet International Confederation of Midwives Standards?

Although the majority of births in Mexico are attended by skilled birth attendants, maternal mortality remains moderately high, raising questions about the quality of training and delivery care. We conducted an exhaustive review of the curricula of three representative schools for the education and clinical preparation of three types of birth attendant – obstetric nurses, professional midwives and general physicians – National Autonomous University of Mexico (UNAM) School of Obstetric Nursing; CASA Professional Midwifery School; and UNAM School of Medicine, Iztacala Campus. All curricular materials were measured against the 214 indicators of knowledge and ability in the International Confederation of Midwives (ICM) skilled attendant training guidelines. The CASA curriculum covered 83% of the competencies, 93% of basic knowledge and 86% of basic abilities, compared with 54%, 59% and 64% for UNAM Obstetric Nursing School and 43%, 60% and 36% for UNAM School of Medicine, respectively. Neither the Obstetric Nursing School nor the School of Medicine documented the quantity or types of clinical experience required for graduation. General physicians attend the most births in Mexico, yet based on our analysis, professional midwives had the most complete education and training as measured against the ICM competencies. We recommend that professional midwives and obstetric nurses should be formally integrated into the public health system to attend deliveries.RésuméLa majorité des accouchements au Mexique bénéficient d’une assistance qualifiée. Pourtant, la mortalité maternelle demeure modérément élevée, ce qui soulève des questions sur la qualité de la formation et des soins obstétricaux. Nous avons étudié le curriculum de trois écoles représentatives pour l’enseignement et la préparation clinique de trois types de personnel obstétrical (infirmières en obstétrique, sages-femmes professionnelles et médecins généralistes): l’École de soins infirmiers obstétricaux de l’Université autonome du Mexique (UNAM), l’École de sages-femmes professionnelles CASA et l’École de médecine de l’UNAM, campus d’Iztacala. Tout le matériel pédagogique a été évalué par rapport aux 214 indicateurs de connaissances et d’aptitudes des directives de formation de la Confédération internationale de sages-femmes pour les accoucheuses professionnelles. Le curriculum CASA couvrait 83% des compétences, 93% des connaissances de base et 86% des aptitudes de base, contre 54%, 59% et 64% pour l’École de soins infirmiers obstétricaux UNAM et 43%, 60% et 36% pour l’École de médecine UNAM, respectivement. Ni l’École de soins infirmiers obstétricaux ni l’École de médecine n’informaient sur la somme ou les types d’expérience clinique requise pour obtenir le diplôme. Les médecins généralistes accouchent la plupart des femmes au Mexique, pourtant, d’après notre analyse, les sages-femmes professionnelles avaient suivi la formation la plus complète selon les critères de la Confédération internationale des sages-femmes en matière de compétences. Nous recommandons d’intégrer officiellement les sages-femmes professionnelles et les infirmières obstétricales dans le système de santé publique pour la surveillance des accouchements.ResumenAunque la mayoría de los partos en México reciben atención calificada, la tasa de mortalidad materna continúa siendo moderadamente alta, lo cual plantea preguntas respecto a la calidad de la capacitación y la prestación de servicios. Realizamos una revisión exhaustiva de los currículos de tres escuelas representativas para la formación y preparación clínica de tres tipos de asistentes de partos – enfermeras obstétricas, parteras profesionales y médicos generales – la Facultad de Enfermería Obstétrica de la Universidad Nacional Autónoma de México (UNAM); la Escuela de CASA de Partería Profesional; y la Facultad de Medicina de la UNAM, Recinto de Iztacala. Todos los materiales curriculares fueron medidos contra los 214 indicadores de conocimiento y capacidad, enumerados en las directrices de la Confederación Internacional de Matronas respecto a la capacitación en atención del parto calificada. El currículo de CASA abarcó el 83% de las aptitudes, el 93% del conocimiento básico y el 86% de las habilidades fundamentales, comparado con el 54%, 59% y 64% para la Facultad de Enfermería Obstétrica de la UNAM y el 43%, 60% y 36% para la Facultad de Medicina de la UNAM, respectivamente. Ni la Facultad de Enfermería Obstétrica ni la Facultad de Medicina documentaron la cantidad o los tipos de experiencia clínica exigidos para graduarse. Los médicos generales atienden la mayoría de los artos en México, pero, de acuerdo con nuestro análisis, las parteras profesionales contaban con formación y capacitación más completas, conforme a las aptitudes citadas por la Confederación Internacional de Matronas. Recomendamos que las parteras profesionales y enfermeras obstétricas se integren oficialmente al sistema de salud pública para atender partos.

Are young cohorts of women delaying first birth in Mexico?

In the last decades, female permanent sterilisation became the most used method of contraception in Mexico. During this time, the demand for pills, condoms and other short-term contraceptives fell consistently. The shift in the demand for contraceptives raises concerns among demographers that the timing of children may remain unchanged regardless of observed reductions in period fertility rates. This paper assesses such ideas in the context of the timing of a first child using duration models as the main analysis tool. Findings suggest that young cohorts of women are effectively delaying first birth relative to the experience of older generations.

Desigualdad en el ingreso, corrupción y esperanza de vida al nacer en México

To ascertain if the effect of income inequality on life expectancy at birth in Mexico is mediated by corruption, used as a proxy of social capital. An ecological study was carried out with the 32 Mexican federative entities. Global and by sex correlations between life expectancy at birth were estimated by federative entity with the Gini coefficient, the Corruption and Good Government Index, the percentage of Catholics, and the percentage of the population speaking indigenous language. Robust linear regressions, with and without instrumental variables, were used to explore if corruption acts as intermediate variable in the studied relationship. Negative correlations with Spearman's rho near to -0.60 (p < 0.05) and greater than -0.66 (p < 0.05) between life expectancy at birth, the Gini coefficient and the population speaking indigenous language, respectively, were observed. Moreover, the Corruption and Good Government Index correlated with men's life expectancy at birth with Spearman's rho -0.3592 (p < 0.05). Regressions with instruments were more consistent than conventional ones and they show a strong negative effect (p < 0.05) of income inequality on life expectancy at birth. This effect was greater among men. The findings suggest a negative effect of income inequality on life expectancy at birth in Mexico, mediated by corruption levels and other related cultural factors.

Risk Factors Associated With Latent Tuberculosis Infection in Mexican American Children

To determine risk factors that are associated with the presence of latent tuberculosis infection (LTBI) in Mexican American children. In this prospective cohort study, we administered tuberculin skin tests (TSTs) and a tuberculosis (TB) risk factor questionnaire to children who were aged 1 to 18 years in immigrant families at a Denver inner-city community health center and elementary school-based health center. Information requested on the questionnaire included child demographics, child and parent birth location, Bacille Calmette-Guérin (BCG) vaccination, and a history and the duration of child and family travel to and visitors from countries where TB is endemic. TST results were read at 48 to 72 hours and were interpreted as positive at 5- and 10-mm induration, depending on risk factor history. All participants received $5 coupons on return for TST reading. Of 584 children enrolled, 96% returned for TST evaluation, median age was 4 years, 48.6% were male, 98.5% were Latino, 66.3% were born in the United States, and 33% were born in Mexico. Overall, 12.4% of children had positive TSTs. For all children in the study, a positive TST was associated with birth in Mexico and no BCG received (adjusted odds ratio [OR]: 15.7; 95% confidence interval [CI]: 1.5-165.2), birth in Mexico and received BCG (adjusted OR: 29; 95% CI: 12.7-66.1), birth in the United States and received BCG (adjusted OR: 9.1; 95% CI: 2.4-34.1), and child travel to Mexico (adjusted OR: 2.8;95% CI: 1.5-5.4). Risk factors for having a positive TST in the 387 children who were born in the United States were travel to Mexico (unable to calculate the OR because all had traveled to Mexico), older age (median: 6 years; adjusted OR: 1.2/year; 95% CI: 1.02-1.40), and a history of BCG vaccination (adjusted OR: 8.2; 95% CI: 2.0-34.0). For the 195 children who were born in Mexico, logistic regression of the following variables showed that none of the variables remained in the model: child age, gender, BCG status, family travel to Mexico, visitors to the United States, child travel to Mexico, years lived in Mexico, and years since BCG. In a population of primarily Mexican American children, those who were born in the United States had an increased risk for developing LTBI when they had a history of BCG vaccination or had traveled to Mexico. For children who were born in Mexico, we were unable to identify additional risk factors for the presence of LTBI, besides their birth in Mexico. Incentives for return for TST reading, such as grocery coupons, are highly effective.

Violations of Reproductive Rights during Hospital Births in Mexico

Denouncing all types of of womens human rights that occur in health care institutions is clearly indispensable for achieving gender equity. But complaints and legal actions alone cannot bring about change. A sociological study of the mechanism that operate between health care providers and their patients and how they contribute to of rights is also necessary. Additionally patterns of interaction and communication as well as submission strategies that characterize physician-patient encounters must be explored. The physician-patient relationship plays a central role in what we call violations of reproductive rights during birth. This article is based on a research project whose general objective has been to identify and examine physical and psychological aspects of abuse that women have suffered. Characterizing dimensions of abuse can help to identify of reproductive rights and formulate interventions that may diminish the problem and help to empower women to defend and protect their reproductive rights. (excerpt)

Addressing inequity in health and health care in Mexico.

Despite the fact that life expectancy at birth in Mexico has improved from forty-two years in 1940 to seventy-three in 2000, major inequalities persist in health and access to health care. The Mexican health care system has evolved into a series of disjointed subsystems that are incapable of delivering universal health insurance. Without greatly restructuring the way health care is financed, performance with respect to equity will remain poor. This paper presents the inequities of the system and describes how the current system contributes to the status quo rather than redressing the situation. After tracing the origins of the present system, we discuss policy initiatives for moving toward universal health insurance.

Association of low maternal education with neural tube defects in Colorado, 1989–1998

Despite increasing use of folate prior to conception, neural tube defects remain among the most common birth defects in the United States. The Study objective was to investigate the maternal and child characteristics associated with having an infant born with a neural tube defect (NTD) in Colorado between 1989 and 1998. Data were derived from a population-based case control study of all live-born infants in Colorado from 1989 to 1998 ( n = 551 285), utilizing birth certificate records and a statewide neural tube defect registry. Chi-square analysis and multiple logistic regression were used to assess the strength of association between sociodemographic characteristics and the main outcome measure, the birth of a child with an NTD. Final analysis was limited to those children born to mothers who themselves were born in either the United States or Mexico. In this ten-year period, there were 251 confirmed cases of NTDs in Colorado, 224 of whom were born to women who were born in either the United States or Mexico. Significant bivariate associations were found between NTDs and the following: female sex of the child, lower maternal age, maternal country of birth in Mexico, and maternal education less than tenth grade. The single strongest predictor of having a child with an NTD was low maternal education (adjusted OR 1.8, 95% CI 1.1–3.1). Low maternal education is an important predictor of having a child with an NTD. In order to further reduce the incidence of neural tube defects, interventions should target women of low educational status. Public Health (2002) 116, 89–94

Association of low maternal education with neural tube defects in Colorado, 1989–1998

Despite increasing use of folate prior to conception, neural tube defects remain among the most common birth defects in the United States. The Study objective was to investigate the maternal and child characteristics associated with having an infant born with a neural tube defect (NTD) in Colorado between 1989 and 1998. Data were derived from a population-based case control study of all live-born infants in Colorado from 1989 to 1998 ( n = 551 285), utilizing birth certificate records and a statewide neural tube defect registry. Chi-square analysis and multiple logistic regression were used to assess the strength of association between sociodemographic characteristics and the main outcome measure, the birth of a child with an NTD. Final analysis was limited to those children born to mothers who themselves were born in either the United States or Mexico. In this ten-year period, there were 251 confirmed cases of NTDs in Colorado, 224 of whom were born to women who were born in either the United States or Mexico. Significant bivariate associations were found between NTDs and the following: female sex of the child, lower maternal age, maternal country of birth in Mexico, and maternal education less than tenth grade. The single strongest predictor of having a child with an NTD was low maternal education (adjusted OR 1.8, 95% CI 1.1–3.1). Low maternal education is an important predictor of having a child with an NTD. In order to further reduce the incidence of neural tube defects, interventions should target women of low educational status. Public Health (2002) 116 , 89–94

A Symposium on the North American Economy

T he North American economy in 1999 was made up of 395 million people, 193 million workers, and $10.3 trillion of annual GDP. According to the OECD, in the U.S. economy, 269 million people and 139 million workers produced $9190 billion in GDP in 1999. The 30 million people and the 16 million workers of Canada produced $624 billion in GDP. The 96 million people and 38 million workers of Mexico produced $475 billion in GDP. This continental economy is staggeringly unequal. Less than 4 percent of Canadian workers and less than 3 percent of U.S. workers are in primary sectors— agriculture, fisheries, and forestry. But one out of five of Mexico’s workers is in the primary sector. GDP per capita in the United States is some $33,900. GDP per capita in Canada at recent exchange rates is $20,400. GDP per capita in Mexico is $4900. Using purchasing power exchange rates to calculate per capita GDP rather than market exchange rates does close the gap a bit. It raises Canada’s per capita GDP to $25,900 per year and Mexico’s to $8100. Even so, the U.S. level is one-third higher than Canada and quadruple that of Mexico. Moreover, within Mexico, the contrasts between the richest portions of the industrial north and the poorest portions of the near-subsistence south are as great as the contrasts between Mexico and the United States. The economic differences between the three nations are, in many ways, greater than the differences in other measures of well-being. Female life expectancy at birth in Mexico at 77 years compares not unfavorably to the 79 years of the U.S. and the 81 years of Canada. Infant mortality in Mexico at 16 per thousand is worse than the eight per thousand of the United States or the six per thousand of Canada—but the gap is not as wide as one might expect based on the per capita GDP figures.

Brutality and Benevolence: Human Ethology, Culture, and the Birth of Mexico

Brutality and Benevolence: Human Ethology, Culture, and the Birth of Mexico

Brutality and Benevolence: Human Ethology, Culture, and the Birth of Mexico.

Preface Introduction Spanish Culture Aztec Culture Coalitions: An Ethological Account of a Coup The Structures of Material Life: Clothing, Shelter, and Community in Sixteenth Century Mexico Food: Dominance and Benevolence in Colonial New Spain The Pursuit of Justice The Hospital: The Right to Distribute Favor Gender and the Creation of Mexico A Question of Methodology Bibliographical Essay Index

Brutality and Benevolence: Human Ethology, Culture, and the Birth of Mexico

Brutality and Benevolence: Human Ethology, Culture, and the Birth of Mexico

Brutality and Benevolence: Human Ethology, Culture, and the Birth of Mexico

Brutality and Benevolence: Human Ethology, Culture, and the Birth of Mexico

Brutality and benevolence: human ethology, culture, and the birth of Mexico

Brutality and benevolence: human ethology, culture, and the birth of Mexico

Lugar de registro y de residencia : problemas y comparabilidad en la clasificación de los nacimientos

In 1973, the classification method for births in Mexico was changed from place of registration to place of mother's residence. "The objective of this work is to analyze how the place of 'customary residence of the mother' has been registered and to determine if the change of classification has some effect [on] the comparability of the information about births in different states. The information analyzed is divided into two periods, according to the way in which it was obtained and processed and the institution responsible for its publication." (SUMMARY IN ENG)

Type of Marriage Ceremony as a Carryover in Acculturation of Mexicans in the United States

A study of 4,750 marriages in Santa Clara County, California, which occurred between 1908 and 1968, and all of which involved participants of Mexican descent, demonstrated a carryover from Mexican to American culture. The character used as a test was the tendency of MexicanAmericans to seek civil rather than religious officiation at the marriage ceremony. That this tendency is derived from the Mexican cultural complex is shown by the facts that, after excluding divorce, persons of Mexican origin react differently from Portuguese and Italian immigrants, and that intermarriage by Mexicans in this country with members of other ethnic groups drastically reduces the number of civil as compared with religious ceremonies. On the other hand the geography of birth exerts relatively little influence, for the choice of type of marriage ceremony has no association with birth in Mexico or the United States. A few years ago a study was made (Borah and Cook 1966) of marital legitimacy in Colonial and Republican Mexico with particular reference to the institution known as union the nearest equivalent of which in our social structure is common-law marriage. Although both states imply the extended extra-legal cohabitation of a man and woman for domestic, not merely casual purposes, the two terms are not synonymous. Common-law marriage carries little if any social, and no legal recognition, and is widely regarded as completely immoral. Union libre, in Mexico has official status, in censuses for example, and, although the offspring of such unions have no rights of inheritance, they are otherwise accepted socially without qualification.