Women and Birth
Volume 29, Issue 5, 2016, Pages e89-e98

International migration as a determinant of emergency caesarean (Note)

Merry L.* , Semenic S. , Gyorkos T.W. , Fraser W. , Small R. , Gagnon A.J.
  • a Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
  • b Ingram School of Nursing, McGill University, Montreal, Quebec, Canada, Women's Health Mission, McGill University Health Centre (MUHC), Montreal, Quebec, Canada
  • c Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Quebec, Canada, Division of Clinical Epidemiology, McGill University Health Centre (MUHC), Montreal, Quebec, Canada
  • d Centre hospitalier universitaire de Sherbrooke (CHUS) Research Centre, Sherbrooke, Quebec, Canada, Department of Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, Quebec, Canada
  • e Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
  • f Ingram School of Nursing, McGill University, Montreal, Quebec, Canada, The Research Institute of the McGill University Health Centre (RI-MUHC), Montreal, Quebec, Canada

Abstract

Background High caesarean rates are of concern given associated risks. International migrant women (women born abroad) represent a substantial proportion of women giving birth in high-income countries (HICs) and face social conditions that may exacerbate childbearing health risks. Among migrant women, emergency rather than planned caesareans, tend to be more prevalent. This method of delivery can be stressful, physically harmful and result in an overall negative birth experience. Research establishing evidence of risk factors for emergency caesareans in migrants is insufficient. Aims (1) Describe potential pathways (with a focus on modifiable factors) by which migration, using internationally recommended migration indicators: country of birth, length of time in country, fluency in receiving-country language, migration classification and ethnicity, may lead to emergency caesarean; and (2) propose a framework to guide future research for understanding “potentially preventable” emergency caesareans in migrant women living in HICs. Discussion “Potentially preventable” emergency caesareans in migrant women are likely due to several modifiable, interrelated factors pre-pregnancy, during pregnancy and during labour. Migration itself is a determinant and also shapes other determinants. Complications and ineffective labour progress and/or foetal distress and ultimately the decision to perform an emergency caesarean may be the result of poor health (i.e., physiological effects), lack of support and disempowerment (i.e., psychological effects) and sub-optimal care. Conclusion Understanding the direct and indirect effects of migration on emergency caesarean is crucial so that targeted strategies can be developed and implemented for reducing unnecessary caesareans in this vulnerable population. © 2016 Australian College of Midwives

Author Keywords

Women's health Emergency caesarean determinants of health international migration Framework

Index Keywords

emergency cultural anthropology Culture birth prenatal care human statistics and numerical data Labor, Obstetric priority journal Note language high income country social status migrant Humans female Socioeconomic Factors risk factor Risk Factors socioeconomics pregnancy obstetric delivery migration Emigration and Immigration ethnicity Parturition Delivery, Obstetric health hazard cesarean section labor
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84963682446&doi=10.1016%2fj.wombi.2016.04.001&partnerID=40&md5=582281d3f89b5acf9742175e34a2ca4c
DOI: 10.1016/j.wombi.2016.04.001
ISSN: 18715192
Cited by: 9
Original Language: English