Cesareans increase among women with higher income and more education
SD. Women with higher levels of income and more education have the highest indexes of frequencies in the practice of C – sections, a situation that seems to be caused by their greater access to private clinics, according to information in the Demography and Health Survey (Endesa) 2013 which places the Dominican Republic with a cesarean section index of 56%, greater than Brazil (52%) and Mexico (45%).
The information from the study indicates that the highest rates of cesareans are presented among women who are most educated, at 72.3% of those that have reached a higher education level (University) and a 60.5% level in the women with a high school education. The lower rates of cesareans are registered in the female population without any education, at 24.8%.
This population is also that which has registered the greatest growth in delivery by C – section when compared to the results of Endesa 2007. For women with higher education there was an increase of 10.7 percentage points going from 61.6% to 72.3%, while those that have a high school education saw an increase of 15.5 percentage points going from 45% to 60.5%.
With regard to the incidence of cesarean births according to income (by quintals), the women that are located in the highest quintile (which is supposed to be the 20% of the population with the highest income) have an incidence of cesarean births of 80.3%, the index which is also the largest increase with 16.7 percentage points since Endesa 2007, when it registered 63.3%.
On the other hand, the women with least income – the poorest 20% of the population – show the least rate of cesarean births with 39.2%. Nonetheless, this female population had the 3rd highest index of cesarean birth increases compared to the information of Endesa 2007, with a registered a rate of 25.8%.
Nonetheless, all of the indexes of the female population in the Dominican Republic without weighing their educational or income levels, are above the rate of no higher than 15% recommended by the World Health Organization (WHO).
Clinics and cesareans, is there a relation?
The information from Endesa 2013 indicates that “the most impressive fact is that in the private sector almost 9 of every 10 births (86.6%)” are done by a C – section. This information appears to have a relation with the high index of birth by cesarean section in women of higher income.
The survey indicates that the more educated is the woman, the greater probability exists that her birth will take place in private clinics, in which 56.9% of those with higher education give birth, against less than 5% of the women with no education or with one to 4 years of primary education.
At the same time, 92.3% of the women belonging to the lowest quintile of income (the poorest 20% of the population) give birth in establishments of the public sector and 4.1% in the private sector, a difference of the women of the higher quintile (the richest 20% of the population) which in their majority go to private centers – 66.5%.
Nonetheless, the rates of cesarean section in the public hospitals have tripled the maximum limit recommended by the WHO, of 15%. According to Endesa 2013, “contrary to what was expected, giving birth in public health establishments implies a high probability of having a cesarean section,” with an index of this practice at 46.1%.
Category: DR News |