Lisa Merry|Rhonda Small|Béatrice Blondel|Anita J. Gagnon
International migration and caesarean birth: a systematic review and meta-analysis
McGill University|La Trobe University|Inserm|McGill University Health Centre|McGill University
perinatal health disparities including disparities caesarean births observed migrant nonmigrant women literature suggests nonmedical factors may implicated systematic review conducted determine migrants western industrialized countries consistently different rates caesarean receivingcountryborn women identify reasons explain differences reports identified searching 12 literature databases inception january 2012 language limits web bibliographic citation handsearches key informants studies compared caesarean rates international migrants nonmigrants living industrialized countries fatal flaw according us preventative services task force criteria included studies summarized analyzed descriptively possible metaanalyzed seventysix studies met inclusion criteria caesarean rates migrants nonmigrants differed 69 studies metaanalyses revealed consistently higher overall caesarean rates subsaharan african somali south asian women higher emergency rates north africanwest asian latin american women lower overall rates eastern european vietnamese women evidence explain consistently different rates limited frequently postulated risk factors caesarean included languagecommunication barriers low ses poor maternal health gdmhigh bmi fetopelvic disproportion inadequate prenatal care suggested protective factors included healthy immigrant effect preference vaginal birth healthier lifestyle younger mothers use fewer interventions childbirth certain groups international migrants consistently different caesarean rates receivingcountryborn women insufficient evidence explain observed differences