title: Obstetric care and method of delivery in Mexico: results from the 2012 National Health and Nutrition Survey.
abstract: OBJECTIVE
  To identify the current clinical, socio-demographic and obstetric factors associated with the various types of delivery strategies in Mexico.
  
  
  METHODS
  This is a cross-sectional study based on the 2012 National Health and Nutrition Survey (ENSANUT) of 6,736 women aged 12 to 49 years. Delivery types discussed in this paper include vaginal delivery, emergency cesarean section and planned cesarean section. Using bivariate analyses, sub-population group differences were identified. Logistic regression models were applied, including both binary and 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 and 49 at the time of their last child birth (OR: 2.54; 95%CI: 2.02-3.20) and 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 and 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, and it is reduced in highly marginalized settings.
authors.affiliation: National Institute of Public Health, Cuernavaca, Morelos, Mexico.
authors.forename: Ileana
authors.initials: I
authors.lastname: Heredia-Pi
authors.affiliation: National Institute of Public Health, Cuernavaca, Morelos, Mexico.
authors.forename: Edson E
authors.initials: EE
authors.lastname: Servan-Mori
authors.affiliation: Center for Global Health and Development, Boston University, Boston, Massachusetts, United States of America.
authors.forename: Veronika J
authors.initials: VJ
authors.lastname: Wirtz
authors.affiliation: National Institute of Public Health, Cuernavaca, Morelos, Mexico.
authors.forename: Leticia
authors.initials: L
authors.lastname: Avila-Burgos
authors.affiliation: National Institute of Public Health, Cuernavaca, Morelos, Mexico; Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America.
authors.forename: Rafael
authors.initials: R
authors.lastname: Lozano
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D006801:Humans; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009749:Nutrition Surveys; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care; D012307:Risk Factors; D012959:Socioeconomic Factors
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