Grant: Travel Awards - Institute Community Support

The high number of caesarean births performed in High Income Countries (HICs) is of concern due to associated costs and health risks. Recommendations to reduce caesarean rates include preventing emergency caesareans (i.e., unplanned caesareans) among low-risk women (i.e., head down, one baby, term pregnancy), particularly for reasons that are subjective (e.g, prolonged labour). Pregnant migrant women (i.e., women born abroad) from low or middle income countries (LMICS) represent a growing population and might have specific health or social needs that could affect pregnancy and childbirth. The objective of this study was to identify medical, migration, social and health service predictors associated with emergency caesareans in low-risk migrant women from LMICs. Results showed that migrant women who were admitted to the hospital in early labour, had a high body mass index or gained excessive weight during pregnancy, had poor general health, had lived in Canada less than two years, or were from Sub-Saharan Africa/Caribbean, were more likely to have an emergency caesarean than a vaginal birth. Among migrant women who lived in Canada less than two years, women who were refugees or were applying for refugee status, or had no official immigration status, were also more likely to have an emergency caesarean birth. Strategies to reduce caesareans in migrant women need to consider medical and non-medical factors. For example, weight control pre- and during pregnancy needs to be addressed and more vulnerable migrant women, including recently-arrived, and those with a "humanitarian" status may need more support during labour. Early admission to hospital should be discouraged to avoid unnecessary or early interventions that may slow labour and lead to a caesarean.