Research Article| Volume 33, ISSUE 6, P574-582, November 2020

Respectful and evidence-based birth care in Mexico (or lack thereof): An observational study

Published:February 25, 2020DOI:



      In Mexico, women are often disrespected and abused during birth, evidence-based practices are seldom used, while outdated and dangerous procedures linger.


      Disrespectful and abusive practices in Mexico have been reported but are not necessarily well-documented; none of the reports so far have relied on direct observation of births.


      To describe birth practices and factors associated with respectful and evidence-based care at 15 referral hospitals in Mexico.


      We observed 401 births from 2010–2016. We analysed woman, provider, and hospital characteristics and their association with the performance of 14 evidence-based and 15 respectful birth practices via descriptive statistics and multiple logistic regression models.


      Only in four births were all the analysed evidence-based and respectful-birth practices performed. Essential interventions like uterine massage was only given to 46.1% of women and the administration of a uterotonic soon after birth only occurred in 58.3% of births. Professionals who were trained in respectful birth care were more likely to address women by their name (Odds Ratio = 3.34, p < 0.05), allow consumption of liquids during labour (Odds Ratio = 31.6, p < 0.05), encourage skin-to-skin contact (Odds Ratio = 31.82, p < 0.05), and examine the placenta after birth (Odds Ratio = 16.55, p < 0.01); they were less likely to perform episiotomies (Odds Ratio = 0.27, p < 0.05).


      This study reveals low rates of evidence-based practices and respectful maternity care but shows training in the topic can have a considerable positive impact. Our results call for further efforts to improve the quality of maternal healthcare, a universal right.


      WHO (World Health Organisation), AMTSL (active management of the third step of labour), ANOVA (analysis of variance), OR (odds ratio)


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