title: [Trends in caesarean sections associated with non-clinical factors in a Birthing Educational Center in Mexico City].
abstract: OBJECTIVE
  To describe the trends in caesarian sections (CS) associated with non-clinical factors in women who attended a birthing educational facility, also known as 'Centro de Educación,' (CEPAPAR) in Mexico City.
  
  
  METHODS
  Data from 992 births of 847 women that occurred from 1988-2000 were analyzed using linear regression to identify the association between non-clinical factors and time-trends in CS.
  
  
  RESULTS
  The overall incidence of CS was 32.8%, with an 8% average annual increase. Until 1994 the percentage of CS remained relatively steady at 30%, increasing to 40% in subsequent years. In analyzing trends in CS and their relationship with non-clinical factors from 1988-2000, the increased incidence of CS during this period was higher among births where no birth attendant was present, for first-time mothers, and in larger hospitals (>50 beds).
  
  
  CONCLUSIONS
  Results show that the increased incidence of CS is associated with non-clinical factors such as size of the hospital and the presence of a birth attendant. A model of support for women which includes information, counseling, and the presence of a birth attendant during labor can contribute to reducing the risk of unnecessary CS in populations such as that studied.
authors.affiliation: Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Campero
authors.forename: Bernardo
authors.initials: B
authors.lastname: Hernández
authors.forename: Ahidée
authors.initials: A
authors.lastname: Leyva
authors.forename: Fátima
authors.initials: F
authors.lastname: Estrada
authors.forename: Jomo
authors.initials: J
authors.lastname: Osborne
authors.forename: Sara
authors.initials: S
authors.lastname: Morales
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data* / Q000639:trends*; D005260:Female; D006801:Humans; D008800:Mexico; D008875:Middle Aged; D011247:Pregnancy; D014505:Urban Population