Mexico is facing a critical situation in obstetric emergency care, combining institutional fragmentation, insufficient hospital infrastructure, and a shortage of specialized medical personnel, according to the study “Maternal and Child Health Care and Obstetric Emergencies During Pregnancy, Childbirth, and the Postpartum Period in Mexico”, prepared by Early Institute.
The research shows that obstetric emergencies — serious complications that can occur during pregnancy, childbirth, or the postpartum period — represent 19% of all hospital discharges registered in the country and up to 61% of hospital discharges related to maternal and child care. In 2023, these complications were associated with 4,871 deaths, a figure the study attributes to structural failures that go beyond the availability of medical resources.
A Fragmented System That Delays Care
According to the Early Institute analysis, the coexistence of different healthcare institutions —the Mexican Social Security Institute (IMSS), the Institute of Security and Social Services for State Workers (ISSSTE), and the Ministry of Health— creates gaps in care and critical delays at moments when every minute can be decisive in saving the life of a mother or newborn.
To address this problem, since 2009 Mexico has had the General Collaboration Agreement for Obstetric Emergency Care, a mechanism designed to guarantee treatment for these cases regardless of the institution to which the patient belongs.
However, the study warns that its implementation remains limited and its real impact has been insufficient, explained Master Cándido Pérez, research coordinator, during a press conference accompanied by Mónica Ancira, from the Maternal and Child Observatory of the Health Department at the Universidad Iberoamericana, and Luis Alarcón, from the Early Institute research team.
Lack of Infrastructure and Specialized Personnel
One of the most significant findings of the study is the gap between existing infrastructure and the level required according to international standards.
In 2023, Mexico had 469 medical units registered under the agreement, while —according to standards established by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF)— the country should have 1,311 units, representing a national deficit of 842 medical facilities.
This shortage is compounded by the lack of specialists. The study explains that most available units have fewer than five obstetrician-gynecologists and six anesthesiologists, professionals who are essential for responding immediately during obstetric emergencies.
Main Causes of Maternal and Neonatal Deaths
Cándido Pérez and Mónica Ancira emphasized that the study identifies the main causes of maternal mortality in Mexico as:
- Postpartum hemorrhage
- Preeclampsia
- Eclampsia
Meanwhile, the most frequent causes of neonatal mortality include:
- Sepsis
- Prematurity
- Respiratory failure
- Fetal malnutrition
Additionally, the research points out that the current catalog of obstetric emergencies excludes 35.5% of causes that, in clinical practice, lead to serious complications, limiting the effective coverage of the interinstitutional agreement.
Guanajuato: A Model to Replicate
In contrast to the national situation, the study highlights Guanajuato as a successful example of interinstitutional coordination.
The state has implemented a specific obstetric emergency system, the Código Mater protocol, and an effective communication network between medical units. These measures have helped reduce response times and improve timely care for patients.
Underreporting: An Obstacle for Public Policies
The study also warns about failures in obstetric emergency reporting systems. These problems not only complicate payment processes between institutions but also prevent the creation of public policies based on reliable and updated evidence.
Ten Recommendations to Address the Crisis
Based on these findings, Early Institute researchers proposed ten recommendations aimed at health authorities and decision-makers:
- Strengthen and expand the agreement as a mandatory national obstetric care network.
- Increase the capacity of secondary-level medical units in states with the greatest deficits: State of Mexico, Mexico City, Jalisco, Puebla, and Nuevo León.
- Update the obstetric emergency catalog to include the 35.5% of currently excluded causes.
- Prioritize the use of the national agreement instead of local agreements with different payment systems.
- Improve medical records and payment processes between institutions to guarantee transparency and continuity of care.
- Train medical personnel at all levels of care for immediate emergency response.
- Adopt an integrated healthcare network model with efficient communication and 24-hour availability.
- Strengthen prevention through timely screening at the primary care level.
- Reform the General Health Law to guarantee clear information and universal, free access to obstetric emergency care.
- Implement immediate information systems and regional integrated networks between institutions.
An Urgent Call for Action
The Early Institute study concludes that although Mexico has a strong legal framework that theoretically guarantees universal access to obstetric emergency care, persistent territorial inequalities, insufficient resources, and failures in institutional coordination continue to cost the lives of mothers and newborns throughout the country.
The research states that strengthening the General Collaboration Agreement for Obstetric Emergency Care and closing the identified infrastructure gap are essential steps to ensure that no woman or newborn dies from causes that, in most cases, are preventable and treatable with timely medical attention.
Source: Early Institute, “Maternal and Child Health Care and Obstetric Emergencies During Pregnancy, Childbirth, and the Postpartum Period in Mexico,” 2026.
Source: elfinanciero
