Caste, tribe, cesareans, and first-time mothers: Differentiating social disparities in surgical births in India

• In Event: 20820 - Section on Medical Sociology Roundtables
  In Refereed Roundtable (90 minute): Table 3. Reproductive Health

Abstract

Whereas childbirth may appear fully medicalized compared to other health events, the degrees vary across social groups. Cesarean section (CS) births in low- and middle-income countries exhibit varying degrees of medicalization such that overuse appears to be increasing for affluent populations while underuse persists for marginalized populations. India’s national CS rate doubled between 2005 (8%) and 2015 (17%) and latest estimates place it at 21.5%. Persistent disparities accompany the rapid increase of CS births, generally favoring CS among women from higher socioeconomic status, affluent regions, and those accessing private facilities. Less is known about patterns of CS disparities by caste and tribe status, one of India’s most persistent axes of social stratification. This study investigates the association of socioeconomic and demographic factors with CS birth in caste/tribe-stratified groups in India. Whereas history of CS is a strong predictor for future CS, first-time (primiparous) mothers tend to have greater odds of CS birth in India. Thus, I limit the study population to first-time mothers. Mixed-effects multilevel models account for district variation in the stratified odds of a CS birth. Age at first birth and place of birth showed the most consistent associations with CS birth across caste/tribe subgroups in this study. Markers of socioeconomic status like women’s education level and household wealth index are not associated with surgical births for all caste and tribe groups.

Author

• Surbhi Shrivastava, Emory University