A Look into Women’s Preventative Care, Contraception Practices and Cesarean Delivery Rates in Rural Guanajuato, Mexico in Comparison to the United States

[In-press]

Authors

  • Nafiah S. Enayet, MD Department of Obstetrics and Gynecology, Mountain Area Health Education Center, Asheville, North Carolina
  • Joi McLaughlin, MD, MS UNC School of Medicine
  • Portia Nleya, MD, MPH UNC School of Medicine
  • Colin Godwin, MPH UNC School of Medicine
  • Vashti Bandy, MD Department of Surgery, Virginia Commonwealth University Health System, Richmond, VA
  • Helen Bui University of North Carolina School of Medicine
  • Taylor Fish, MD Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC
  • Sloan Walters University of North Carolina School of Medicine, Chapel Hill, NC; Kenan-Flagler School of Business, University of North Carolina at Chapel Hill, Chapel Hill, NC
  • Salomon Ariza University of North Carolina School of Medicine, Chapel Hill, NC
  • Kendall Conder Center for AIDS Research, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC

DOI:

https://doi.org/10.47265/cjim.v1i1.553

Abstract

Statement of Significance

According to the World Health Organization (WHO), a third of health issues for women aged 15 and 44 years are sexual and reproductive health problems with unsafe sex practices being a major risk factor.1 Additionally, “every day in 2017, approximately 810 women died from preventable causes related to pregnancy and childbirth.”2 Although there have been improvements in prenatal and postpartum care, these benefits do not extend worldwide. Cervical and breast cancer represent additional issues in women’s health wherein adequate preventative medicine can dramatically improve patient outcomes. Our findings provide insight into the use of accessible contraception, preventive screenings, and cesarean deliveries based on the self-reported experience of a rural population near Guanajuato, Mexico. The results stand to inform future research and public health efforts in the region aiming to improve knowledge and use of contraception, investigate increasing cesarean delivery rates, and improve screening rates for cervical and breast cancer.

Background: The objective of this study was to evaluate preventative screening for breast and cervical cancer, contraceptive practices, and cesarean section rates for women in rural Guanajuato Mexico. Understanding this data is important because such accessibility and healthcare practices can influence the safety of this population’s lives as well as provide insight to the impact of public healthcare programs.

Methods: A twenty-one question oral survey was administered to both male and female participants of health fairs and screenings in seven rural communities around the cities of Juventino Rosas and San Miguel de Allende. The survey covered diet and exercise habits as well as women’s health topics for participants who self-identified as female. Women’s health topics included questions about mammography & Papanicolaou test (Pap test) history as well as contraception use and cesarean section history.

Results: A total of 155 participants. Mean respondent age was 46 years and a majority of respondents were female (81%, n = 155). Of female respondents, almost half reported a previous cesarean section. More women in the younger cohort (aged <50 years) reported a history of cesarean section compared to the older cohort (aged >50 years), but not at a level of statistical significance. Almost half of the women of childbearing age denied contraception utilization. Most women (72%, n = 110) reported a Pap test within the past five years and about a third had one within the past year. Of the women aged >40 years, almost half had not received mammography.

Conclusions: Younger women appeared more likely to have had at least one cesarean delivery than older women, but the sample size provided inadequate power for statistical significance. Access to contraception did not appear to be a barrier to contraception utilization in this region, an important finding for future investigations of associated topics, such as rates of unplanned pregnancies or the spread of communicable sexual diseases. Though the Pap test rates were comparable to that of the United States, mammogram rates lagged. Further studies should investigate increasing cesarean delivery rates in rural Guanajuato, Mexico, strategies to increase education regarding contraceptive modalities, and approaches to improve screening and treatment of cervical and breast cancer.

Author Biographies

Nafiah S. Enayet, MD, Department of Obstetrics and Gynecology, Mountain Area Health Education Center, Asheville, North Carolina

Nafiah S. Enayet, MD is a first-year resident training in Obstetrics and Gynecology at the Mountain Area Health Education Center, Asheville, NC.

Joi McLaughlin, MD, MS, UNC School of Medicine

Joi McLaughlin, MD, MS is a first-year resident training in Pediatrics at the University of North Carolina School of Medicine, Chapel Hill, NC.

Portia Nleya, MD, MPH, UNC School of Medicine

Portia Nleya, MD, MPH is a first-year resident training in Internal Medicine at the University of North Carolina School of Medicine, Chapel Hill, NC.

Colin Godwin, MPH, UNC School of Medicine

Colin Godwin, MPH is a fourth-year medical student at the University of North Carolina School of Medicine, Chapel Hill, NC.

Vashti Bandy, MD, Department of Surgery, Virginia Commonwealth University Health System, Richmond, VA

Vashti Bandy, MD is a first-year resident training in Surgery at the Virginia Commonwealth University Health System, Richmond, VA.

Helen Bui, University of North Carolina School of Medicine

Helen Bui is a fourth-year medical student at the University of North Carolina School of Medicine, Chapel Hill, NC.

Taylor Fish, MD, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC

Taylor Fish, MD is a first-year resident training in Pediatrics at the University of North Carolina School of Medicine, Chapel Hill, NC.

Sloan Walters, University of North Carolina School of Medicine, Chapel Hill, NC; Kenan-Flagler School of Business, University of North Carolina at Chapel Hill, Chapel Hill, NC

Sloan Walters is a fourth-year student in the joint MD-MBA program at the University of North Carolina School of Medicine and the University of North Carolina at Chapel Hill Kenan-Flagler School of Business, Chapel Hill, NC.

Salomon Ariza, University of North Carolina School of Medicine, Chapel Hill, NC

Salomon Ariza is a first-year medical student at the University of North Carolina School of Medicine, Chapel Hill, NC.

Kendall Conder, Center for AIDS Research, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC

Kendall Conder is a research assistant at the University of North Carolina at Chapel Hill Center for Aids Research, Chapel Hill, NC.

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Published

2021-09-28

How to Cite

Enayet, N., McLaughlin, J., Nleya, P., Godwin, C., Bandy, V., Bui, H., Fish, T., Walters, S., Ariza, S., & Conder, K. (2021). A Look into Women’s Preventative Care, Contraception Practices and Cesarean Delivery Rates in Rural Guanajuato, Mexico in Comparison to the United States: [In-press]. Carolina Journal of Interdisciplinary Medicine, 1(1), 15 -. https://doi.org/10.47265/cjim.v1i1.553