{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T10:34:14Z","timestamp":1781260454782,"version":"3.54.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Glob. Women\u2019s Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The COVID-19 pandemic has disrupted maternal and postnatal care globally, particularly in low- and middle-income countries. This study investigated sociodemographic, geographic, psychosocial, and obstetric factors associated with inadequate postnatal care utilization in Mexico City during the pandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a cross-sectional survey among 719 postpartum women at a major obstetric hospital in Mexico City. Maternal sociodemographic data, social support (MOS survey), prenatal care quality (Kessner Index), postnatal depression (Edinburgh Scale), care satisfaction (SERVQUAL), and obstetric history were assessed. Spatial regression models evaluated associations between maternal factors, socioeconomic status (AMAI Index), and postnatal visits, incorporating geographic dependencies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significant spatial autocorrelation in postnatal visit frequency was observed (<jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200914.07; <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001) indicating geographic dependencies in healthcare utilization. Higher consultation rates were associated with being a non-qualified worker (<jats:italic>\u03b2<\/jats:italic>\u2009=\u20090.252), living with a domestic partner (<jats:italic>\u03b2<\/jats:italic>\u2009=\u20090.196), and belonging to the medium-low socioeconomic group (<jats:italic>\u03b2<\/jats:italic>\u2009=\u20090.297). Maternal education showed no significant association. The spatial error term confirmed significant geographic dependencies (<jats:italic>\u03b2<\/jats:italic>\u2009=\u2009\u22120.153, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Geographic location, occupation, and socioeconomic status significantly influence postnatal visit frequency during public health crises, while education plays a lesser role. These findings suggest the need for targeted interventions addressing geographic barriers and incorporating mental health support to enhance maternal healthcare access among vulnerable populations. Future research should focus on developing integrated care frameworks that can better withstand disruptions during public health emergencies.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fgwh.2025.1538565","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T05:44:27Z","timestamp":1748583867000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Barriers to postnatal care utilization during the COVID-19 pandemic: a cross-sectional study of sociodemographic and spatial factors in Mexico City"],"prefix":"10.3389","volume":"6","author":[{"given":"Magalhi","family":"Robledo-Clemente","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Silva God\u00ednez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc\u00eda Daniela","family":"Garc\u00eda Montes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Valencia-Ortega","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata","family":"Saucedo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e759","DOI":"10.1016\/S2214-109X(21)00079-6","article-title":"Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis","volume":"9","author":"Chmielewska","year":"2021","journal-title":"Lancet Glob Health"},{"key":"B2","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1363\/46e9020","article-title":"Estimates of the potential impact of the COVID-19 pandemic on sexual and reproductive health in low- and middle-income countries","volume":"46","author":"Riley","year":"2020","journal-title":"Int Perspect Sex Reprod Health"},{"key":"B3","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1002\/ijgo.13397","article-title":"Maternal mental health and coping during the COVID-19 lockdown in the UK: data from the COVID-19 new mum study","volume":"151","author":"Dib","year":"2020","journal-title":"Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fgwh.2020.00001","article-title":"Moms are not OK: cOVID-19 and maternal mental health","volume":"1","author":"Davenport","year":"2020","journal-title":"Front Glob Womens Health"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e635","DOI":"10.1016\/S2214-109X(14)70309-2","article-title":"Estimation of daily risk of neonatal death, including the day of birth, in 186 countries in 2013: a vital-registration and modelling-based study","volume":"2","author":"Oza","year":"2014","journal-title":"Lancet Glob Health"},{"key":"B6","doi-asserted-by":"publisher","first-page":"259","DOI":"10.2471\/BLT.14.140996","article-title":"Inequities in postnatal care in low- and middle-income countries: a systematic review and meta-analysis","volume":"93","author":"Langlois","year":"2015","journal-title":"Bull World Health Organ"},{"key":"B7","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1186\/s12889-020-08480-4","article-title":"Inequalities in the utilisation of maternal health care in rural India: evidences from national family health survey III & IV","volume":"20","author":"Ali","year":"2020","journal-title":"BMC Public Health"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1464","DOI":"10.3390\/ijerph17051464","article-title":"Understanding barriers and facilitators of maternal health care utilization in central Myanmar","volume":"17","author":"Milkowska-Shibata","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"B9","first-page":"4","article-title":"Factors associated with a lack of postnatal care","volume":"60","author":"Contreras-S\u00e1nchez","year":"2022","journal-title":"Rev Medica Inst Mex Seguro Soc"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1384","DOI":"10.1093\/heapol\/czab099","article-title":"An assessment of geographical access and factors influencing travel time to emergency obstetric care in the urban state of Lagos, Nigeria","volume":"36","author":"Banke-Thomas","year":"2021","journal-title":"Health Policy Plan"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1907","DOI":"10.1002\/(SICI)1097-0258(19960930)15:18%3C1907::AID-SIM402%3E3.0.CO;2-R","article-title":"The spatial relationship between infant mortality and birth defect rates in a U. 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