Socioeconomic Determinants of Planned and Emergency Cesarean Section Births in Mexico

Mexico’s rapid increase in Cesarean section (C-section) births in the past 20 years parallels a trend occurring in other low- and middle-income countries across the globe, exceeding what is considered medically necessary. Although existing research has highlighted how social forces shape the role of “demand” factors related to women’s preference for C-section births and “supply” factors in health care settings where women give birth, it does not differentiate these births according to whether they were planned earlier in pregnancy or emergency C-sections initiated while a woman was in labor. The objective of this study is to assess the socioeconomic determinants of planned and emergency C-section births. In this study, we use nationally representative data from the 2014 Encuesta Nacional de la Dinamica Demografica (ENADID) to examine determinants of planned and emergency C-section births for women who experienced their first birth within the past 5 years (N = 8710). Logistic regression analysis is employed to examine predictors of planned and emergency C-section births separately. Of the births in our sample, 49.2% were vaginal, 18.5% were planned C-sections, and 32.4% were emergency C-sections. We find that wealth and birth location are significant predictors of planned, but not emergency C-sections. Socioeconomic factors are important determinants of planned C-section births and represent a pathway through which social influence should be examined in the future when looking at the adaptation of surgical births in populations and health care system efforts to reduce the C-section rate.