Obstetric Care Method of Delivery in Mexico: Results from the 2012 National Health Nutrition Survey

Abstract

Objective: To identify the current clinical, socio demographic obstetric factors associated with the various types of delivery strategies in Mexico. Materials Methods: This is a cross sectional study based on the 2012 National Health Nutrition Survey (ENSANUT) of 6,736 women aged 12 to 49 years. Delivery types discussed in this paper include vaginal delivery, emergency cesarean section planned cesarean section. Using bivariate analyses, sub population group differences were identified. Logistic regression models were applied, including both binary multinomial outcome variables from the survey. The logistic regression results identify those covariates associated with the type of delivery. Results: 53.1% of institutional births in the period 2006 through 2012 were vaginal deliveries, 46.9% were either a planned or emergency cesarean sections. The highest rates of this procedure were among women who reported a complication during delivery (OR: 4.21; 95%CI: 3.66–4.84), between the ages of 35 49 at the time of their last child birth (OR: 2.54; 95%CI: 2.02–3.20) women receiving care through private healthcare providers during delivery (OR: 2.36; 95%CI: 1.84– 3.03). Conclusions: The existence of different socio demographic 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, it is reduced in highly marginalized settings.