[Caesarean sections in Mexico: tendencies, levels and associated factors].
OBJECTIVE
To describe the rate of caesarean sections in Mexico in the last 10 years and evaluate its relationship with several socioeconomic variables, type of health care services, and specialists' availability.


METHODS
The Ministry of Health's register of births was used as source of information. The dependent variable was the type of delivery (vaginal or caesarean). The independent variables were: gross domestic product, human development index, illiteracy percentage among women, social exclusion index and, gynecology and obstetrics specialists supply. Correlations between variables were evaluated using Pearson's parametric test and Spearman range test. A lineal multiple regression was used to model the national caesarean data of 1999.


RESULTS
National caesarean percentage increased in the last 10 years at an annual rate of 1%. It was considerably higher in social security institutions and the private sector. Caesareans percentages in 1999 were slightly above 35%. The highest values were those of the private sector with 53%, followed by social security institutions, with 38.2%. The variables more strongly associated with C sections were GDP, specialists' availability and human development index.


CONCLUSIONS
It seems reasonable to advocate for a widespread descent in caesarean sections in Mexico. Important declines in certain contexts have been witnessed by implementing measures such as a second opinion before any C-section, a precise definition of the reasons for using it, and the monitoring of individual caesarean percentage among hospital obstetricians.
Puentes-Rosas
Esteban
E
Dirección General de Información y Evaluación del Desempeño, Secretaría de Salud, México, DF, México. epuentes@salud.gob.mx
Gómez-Dantés
Octavio
O
Garrido-Latorre
Francisco
F
D002585:Cesarean Section / Q000706:statistics & numerical data* / Q000639:trends*; D005260:Female; D006801:Humans; D008800:Mexico; D011247:Pregnancy; D012959:Socioeconomic Factors