Do Cesarean Delivery rates rise when the economy declines? A test of the economic stress hypothesis

Abstract

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Economic Crisis Impact and Social Determinants of Perinatal Outcomes and Infant Mortality in Greece

“…Exploring the literature, two models of crisis impact on perinatal and infant health have been proposed [ 44 ]: A physiological model, which defines physiological pathways connecting economic conditions with health outcomes [ 21 , 22 , 23 , 24 , 25 ], and a healthcare model, which investigates the health outcomes in relation to the access to adequate and appropriate healthcare [ 26 , 27 , 28 , 44 ]. The design of the present study does not permit the investigation of possible physiological pathways connecting the economic crisis with health outcomes.…”

“…Studies exploring the mechanisms through which economic conditions affect children’s health suggest that malnutrition, infections, insufficient immunization, an increase of risky behaviors of parents, as well as changes in cohort composition may explain the effects on health outcomes [ 18 , 19 , 20 ]. Other studies suggest that economic stress has direct physiological effects, including a direct impact on the levels of several hormones and biomarkers, affecting fetuses and resulting in adverse outcomes [ 21 , 22 , 23 , 24 , 25 ]. On the other hand, harsh economic conditions are associated with reduced access to appropriate healthcare and with a deterioration of the maternal, neonatal, and infant care, which may be responsible for the deterioration of the corresponding health outcome [ 18 , 26 , 27 , 28 ].…”