[Trends in caesarean sections associated with non-clinical factors in a Birthing Educational Center in Mexico City].

OBJECTIVES To describe the trends in caesarian sections (CS) associated with non-clinical factors in women who attended a birthing educational facility, also known as 'Centro de Educación,' (CEPAPAR) in Mexico City. METHODS Data from 992 births of 847 women that occurred from 1988-2000 were analyzed using linear regression to identify the association between non-clinical factors and time-trends in CS. RESULTS The overall incidence of CS was 32.8%, with an 8% average annual increase. Until 1994 the percentage of CS remained relatively steady at 30%, increasing to 40% in subsequent years. In analyzing trends in CS and their relationship with non-clinical factors from 1988-2000, the increased incidence of CS during this period was higher among births where no birth attendant was present, for first-time mothers, and in larger hospitals (>50 beds). CONCLUSIONS Results show that the increased incidence of CS is associated with non-clinical factors such as size of the hospital and the presence of a birth attendant. A model of support for women which includes information, counseling, and the presence of a birth attendant during labor can contribute to reducing the risk of unnecessary CS in populations such as that studied.