Bullying at birth?: obstetric violence laws and c-section rates in Mexico

Abstract

This research explores the effect that changes in Mexican legislations (Local Laws and Penal Codes) have in the rate of c-sections (CS). The research hypothesis is that if health providers perceive higher non-monetary costs when performing unnecessary CS (i.e. less protection from their superiors, legal threats or mayor vigilance on all stages of obstetric care), the probability of using these procedures will be lower. For this purpose, this study will use panel data at state level from Mexico’s birth certificates 2008-2016 exploring the effects over the temporal and geographical variation. Using econometric tools, this research finds that there is a negative and significant decrease of the rate of CS when typifying Obstetric Violence (OV) in states’ Penal Codes, but no effect only when included in Local Laws. Also, this thesis finds that these legislative reforms diminish more the CS rates for younger and less educated mothers and that centralized health institutes (like the Health Ministry: SSA) lower their rates when a new law is added. Thirdly, it shows that CS are, sometimes, unnecessary procedures as physicians are less likely to perform them on non-working days. Finally, it shows that there is not strong evidence on whether CS improved mothers and newborn’s health.