Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #116736

Karla Berdichevsky, MD, MPH¹, Diana Lara, MD, ScM², Sandra G. Garcia, ScM, ScD³, Margaret A. Handley, PhD⁴, and Enrique Gonzalez, MD⁴. (1) Regional Office for Latin America and the Caribbean, The Population Council, Panzacola 62- 102, Villa Coyoacan, Mexico City, 04000, Mexico, (2) Reproductive Health Program, Population Council, Panzacola 62-102, Col. Villa Coyoacán, Mexico, Mexico, 52-55-59998630, dlara@popcouncil.org.mx, (3) Director of Reproductive Health for Latin America and the Caribbean, Population Council, Regional Office for Latin America and the Caribbean - Mexico City, c/o One Dag Hammarskjold Plaza, New York, NY 10017, (4) Department of Family and Community Medicine, University of California, San Francisco, 500 Parnassus Ave., San Francisco, CA 94143-0900

The majority of Mexican women who migrate to the United States (US) do so without documentation or complete knowledge of their medical histories, including information about previous cesarean delivery and the type of uterine incision used for the procedure. Uterine incision type is a key factor in physician decision making about whether or not a woman can attempt a vaginal birth after a previous cesarean (VBAC). As part of a binational research effort and in order to help reduce the number of unnecessary repeat cesareans among Mexican migrant women in the US, we are conducting a study to determine 1) the prevalence of different incision types used in Mexico; 2) Mexican physician attitudes and practices vis á vis cesarean delivery and VBAC; and Mexican women's attitudes and experience with cesarean delivery. Preliminary results include: Prevalence of transversal incisions for cesarean delivery is over 95% in Mexico; most physicians are unaware of the implications of incision type on women's opportunity for VBAC; Mexican women's perceptions of cesarean delivery are characterized by fear of pain and most would prefer subsequent vaginal deliveries; there is very limited information exchange between physicians in Mexico and the US. Results indicate the need for systematic exchange of information between physicians in Mexico and the US. One such strategy is the development and use of health cards documenting clinical birth histories, which migrant women can carry and share with providers in both Mexico and the US.

Learning Objectives: At the end of the session, participants will be able to

• List three characteristics of Mexican physician attitudes on cesarean deliveries
• Name three characteristics of women´s experiences with cesarean deliveries
• Understand the importance of establishing mecanisms for medical information exchange between Mexico and the United States

Keywords: Access Immigration, Pregnancy Outcomes

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.