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Table 3 Potential mechanisms & risk factors involved in caesareans among migrants

From: International migration and caesarean birth: a systematic review and meta-analysis

Mechanism/Risk factor* Number of studies
Income and social status
Low SES (education, income) 15
Higher social status 5
No legal status 2
Poor nutritional status 1
Social support networks
No partner and/or family, friends 4
Education and literacy
High education 3
Employment and working conditions
Low status job 1
Social environment
Poor living conditions 2
Physical environment
Violence, trauma or experiences of abuse 1
Personal health practices
High BMI &/or Gestational diabetes/diabetes 12
Smoking, drug or alcohol abuse 1
Healthy child development
Fetal distress 6
Low birthweight 3
Prematurity 2
Biology and genetic endowment
Illness and other pathologies (e.g., anaemia, hepatitis, TB, malaria, HIV/STIs, parasitic or other infections) 14
Pelvis shape/size (feto-pelvic disproportion) 13
Older age 7
Short stature 4
Pre-eclampsia/hypertension 4
Prolonged labour/failure to progress 3
Post-datism 3
Health services
Language/communication barriers 18
Lack of healthcare including prenatal care 10
Discrimination/racism 1
Hospital environment 1
Gender
Genital cutting 7
Culture
Beliefs/preferences about birth 8
Grand-multiparity 8
Inter-racial marriage (leading to large birthweight babies) 4
Acculturation (adoption of unhealthy lifestyles) 3
Different concepts of health and disease (leading to different health seeking behaviour) 2
Reduced food intake during pregnancy (to have a smaller fetus) 1
  1. * Mechanisms/Risk Factors are organized under 12 determinants of population health (Public Health Agency of Canada (PHAC). Immigration and Health-Exploring the Determinants of Health. Ottawa: Public Health Agency of Canada; 2011).
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