Health literacy, socioeconomic disparities and health outcomes: the role of antenatal education in the use of caesarean sections

This literature review investigates the socioeconomic disparities affecting childbirth outcomes among women in high-income countries. Studies reveal that low-income women are more likely to deliver via caesarean section than their higher-income counterparts. While the underlying causes of this disparity are not fully understood, recent published studies emphasize the critical role of antenatal education on the probability of a caesarean section. Antenatal education participation is strongly correlated with a woman's socioeconomic status, with economically disadvantaged women being less likely to attend such programs. The result is a direct and indirect effect of patient socioeconomic status leading to caesarean section: poor attendance of antenatal education by the most disadvantaged women explains why they deliver more often by caesarean section than the majority of women. This review shows how increasing participation in antenatal education and targeting low-income women could improve maternal health outcomes while also reducing associated healthcare costs. Finally, we propose strategies to enhance the current system, focusing on promoting and expanding antenatal education, especially for economically disadvantaged pregnant women.