Is birth the 'old-fashioned way' on its way out in Mexico?

Mexico has the highest rate of Caesarean surgeries in Latin America. Doctors and patients who prefer the convenience of scheduling birth are just one factor playing a role in Mexico's ranking.

Is birth the old-fashioned way on its way out in Mexico?

The sight of a pregnant woman in labor has become increasingly rare in Mexican hospitals, which now have the highest rate of Caesarean procedures in Latin America. Nearly one in two women give birth by C-section in Mexico today in public and private hospitals; in private hospitals alone, the rate is 70 percent.

Caesarean rates in Mexico far surpass World Health Organization (WHO) recommendations for a target rate between 10 and 15 percent and are beginning to draw scrutiny.

“It’s been high for awhile but it’s climbed to alarming levels,” says Glenda Furszyfer, a doula, or birth assistant, in Mexico City

The factors driving the rising rates of C-sections are numerous, ranging from Mexican consumers’ increasing economic power to lopsided insurance payouts that favor surgery, as well as doctors and patients who prefer the convenience of scheduling birth.

There is also the example set by its northern neighbor: Caesarean rates hit their highest in the United States in 2009 at nearly 33 percent, according to the American College of Obstetricians and Gynecologists (ACOG). Despite ACOG’s recommendations that hospitals limit C-sections to cases where the health of the mother or baby is at risk in a vaginal birth, the rate hasn’t abated.

“It’s a reflection,” says Dr. Jorge Kunhardt, director of Medica Sur Lomas, an upscale private women’s hospital that encourages fewer C-sections. “Whatever happens in the US, we learn it here in Mexico.”

And yet Mexico has far surpassed US rates, prompting concerned health professionals and consumer advocates to question the risks to women and families of so few natural births.

The only choice?

When Mariana Granados told her Mexico City gynecologist that she and her partner were planning a pregnancy, she says the doctor spoke about Caesarean surgery as if it was the only option. It was a natural recommendation: The gynecologist herself had two C-sections, as had the other doctor with whom she shared a practice.

“I wanted something more natural,” Ms. Granados says, so she switched doctors and hired a doula, Ms. Furszyfer.

In Mexico and across Latin America, rising incomes have led more couples to choose private hospital care and more technology in birth, including C-sections. According to the WHO, a doubling of income corresponds to a 77 percent increase in the rate of Caesarean.

Although studies show Caesareans can present higher risks to the woman and baby compared with vaginal delivery, practitioners in Mexico say doctors rarely discuss these risks with patients. Longer hospital stays, exposure to infections after the operation, and greater complications in subsequent pregnancies are a few issues cited by ACOG. Infants born through C-section face an increased risk of respiratory problems and more often struggle to breastfeed.

Recent research has also linked Caesarean sections to higher rates of obesity in young children, one theory being that these children miss the crucial intestinal bacteria that must be acquired in the birth canal.

Still, the pressures to choose the relative knowns of surgery over the unknowns of natural labor continue to press doctors and patients toward the former.

“Caesarean section gives us much greater control,” says Dr. Francisco Padilla Del Toro, head of a public hospital in Mexico City’s San Angel neighborhood. “Yes, there are more risks in Caesareans, but the control over those risks is much greater.”

Then there are insurance concerns, for doctors and patients. Many private Mexican health plans pay for Caesareans but not for vaginal birth, even though at a private hospital the costs are similar, about $4,000 for vaginal delivery and $6,000 for a C-section. Doctors at private hospitals opt more quickly for C-sections if complications arise due to the threat of lawsuits – likewise one of the driving reasons for the high US Caesarean rate.

“There is no question that where there is an unfavorable climate for getting sued, physicians have [a] lower threshold for when they decide to perform a Caesarean,” says Dr. George Macones, chair of obstetrics and gynecology at Washington University in St. Louis.

Doctors feel the economic pressures day to day, as well, not just in malpractice.

“Financial incentives play an important role,” says Katia Garcia, a researcher with Mexico City-based consumer rights group El Poder del Consumidor, which works to educate women about their birth options. “Doctors that can program Caesareans all day earn a lot more.”

Against the grain

Granados gave birth to a boy, Luciano, nearly two months ago at Medica Sur Lomas, the hospital that encourages fewer C-sections (although the hospital’s rate is still well above the recommended average at 53 percent). He was born in water, without many of the typical hospital interventions and no pressure to have a Caesarean, she says.

“In Mexico at least, women opt for Caesarean with the idea they won’t suffer,” she says. “But you realize that [in vaginal birth] you recover much more quickly. It makes me sad that Caesareans are such a common, dominant practice.”

Her family and friends treat her experience like a rarity, she says. “No one can believe I had a natural birth.”

You've read  of  free articles. Subscribe to continue.
Real news can be honest, hopeful, credible, constructive.
What is the Monitor difference? Tackling the tough headlines – with humanity. Listening to sources – with respect. Seeing the story that others are missing by reporting what so often gets overlooked: the values that connect us. That’s Monitor reporting – news that changes how you see the world.

Dear Reader,

About a year ago, I happened upon this statement about the Monitor in the Harvard Business Review – under the charming heading of “do things that don’t interest you”:

“Many things that end up” being meaningful, writes social scientist Joseph Grenny, “have come from conference workshops, articles, or online videos that began as a chore and ended with an insight. My work in Kenya, for example, was heavily influenced by a Christian Science Monitor article I had forced myself to read 10 years earlier. Sometimes, we call things ‘boring’ simply because they lie outside the box we are currently in.”

If you were to come up with a punchline to a joke about the Monitor, that would probably be it. We’re seen as being global, fair, insightful, and perhaps a bit too earnest. We’re the bran muffin of journalism.

But you know what? We change lives. And I’m going to argue that we change lives precisely because we force open that too-small box that most human beings think they live in.

The Monitor is a peculiar little publication that’s hard for the world to figure out. We’re run by a church, but we’re not only for church members and we’re not about converting people. We’re known as being fair even as the world becomes as polarized as at any time since the newspaper’s founding in 1908.

We have a mission beyond circulation, we want to bridge divides. We’re about kicking down the door of thought everywhere and saying, “You are bigger and more capable than you realize. And we can prove it.”

If you’re looking for bran muffin journalism, you can subscribe to the Monitor for $15. You’ll get the Monitor Weekly magazine, the Monitor Daily email, and unlimited access to

QR Code to Is birth the 'old-fashioned way' on its way out in Mexico?
Read this article in
QR Code to Subscription page
Start your subscription today