INTRODUCTION
Cesarean births have been associated with increased in several westernized and urbanized contexts. Cesarean births are also rising globally among the rural poor, though little is known about longer-term child health implications of cesarean birth in rural and impoverished settings. In a Yucatec Maya subsistence farming community of Xculoc, the cesarean birthrate is rising. Previous research demonstrated that cesarean births are associated with poorer breastfeeding outcomes in Xculoc. We now examine whether mode of birth is also associated with altered child growth outcomes in this geographically isolated subsistence community. We test whether birth mode (vaginal/cesarean) is associated with alterations in child growth patterns. We hypothesize that cesarean births will be associated with larger body size in …show more content…
For example, poor women who have had cesareans may lack the resources to pay for prolonged postnatal hospital care. There may be additional negative consequences of increasing cesarean rates in remote and impoverished communities. In particular, the link between cesarean births and immunopathologies and obesity may exacerbate chronic disease “epidemics” that are underway due to the nutritional transition (Leatherman and Goodman 2005). Obesity is already an epidemic and a major public health crisis in Mexico (Barquera and Rivera 2013). Though obesity rates are currently highest in non-indigenous Mexicans (Stoddard et al 2011), indigenous populations are particularly susceptible to its negative health effects as they navigate nutritional and epidemiologic transitions (Malina et al 2007). In the rapidly modernizing study population, I expect that cesarean births will be associated with larger body size in children, and this will be evident by age