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Cesarean Rate in Brazil- 82 Percent and rising
By admin June 6, 2014

The rise of Cesarean rates in Brazil has been brought into question after the story of Mrs. Adelir Carmen lemos De Goés broke in April of 2014. Authorities detained Mrs. De Goés after checking herself out of Torres hospital where earlier she opted not to have a Cesarean section, rather return when her contractions were less than five minutes apart for her preferred natural delivery. The hospital doctors responded by obtaining a court order authorizing the authorities  to detain Mrs. De Goés and return her to Torres Hospital where she then had the Cesarean section.

The current rate of Cesarean sections in Brazil is 82%, including both private healthcare, and the SUS universal healthcare, systems. Considering the recommended rate of Cesareans by the World Health Organization Is 10 to 15%, experts on both sides of the argument have come out to explain Brazil’s high percentage, with proponents citing the personal preferences of Brazilian women and opposition rebutting with economics and obstetrician coercion as its cause.

Many Brazilian women elect to have Cesarean sections over natural birth. Defenders argue that women see the procedure as more convenient and sterile than natural delivery. In fact, a 2011 study detailing the patterns of Cesarean delivery in Brazil showed that Cesarean were almost universal with 81% of wealthy patients undergoing the procedure and 45% of SUS patients as well. They also show a positive correlation between the cesarean procedures in SUS patients who also underwent maternal schooling (Barros et al 2011). Defenders cite this preference also to the regard of childbirth in Brazil as ugly and inconvenient, with a Cesarean offering a degree of elegance to the entire ordeal, thus making it a status symbol for wealthier women.

Adelir De Goés with her new baby

Adelir De Goés with  newborn baby girl

However, opposition claims that a procedure that once was a status symbol has now evolved into a financial money factory for Brazilian hospitals, regardless ofthe woman’s preference. They argue the rising rate is due to obstetricians scheduling as many cesareans as they can fit within their shift to make the most money from the insurance plan, which would absorb most of the cost.  Opponents further insist that Obstetricians also forcibly coerce patients into a Cesarean, even when the mother has elected for natural delivery, by verbally berating them with comments about her inability to deal with childbirth pain and her cervix not dilating fast enough. Many Brazilian women concede to this notion, citing their reasoning for a cesarean was their fear of this very treatment by their doctor if they went natural.  The 2014 case study by Dr. Xiaohui Hou reaffirms this belief, explaining that a combination of cultural belief, fear of patient care quality, and the physician’s desire for convenient work hours, are the major factors in rising Cesarean rates for Brazil and China (Hou et al 2014).

Cesarean pose serious risk to fetal health as well. Infants born from cesareans have a greater likelihood of respiratory troubles after birth because the labor contractions, which would normally prepare fetal lungs for respiration at birth, are not present. Moreover, inducing pregnancies risk the fetus arriving preterm, which impairs necessary body developments. This risk is particularly concerning in Brazil, where women plan their Cesareans far ahead of time.  The difference of one week, for example, can have severe effects on the fetus. For the sake of convenience, Cesareans risk severely impairing infant development potentially leaving the child with permanent impairments.

Cesareans present a safe alternative to natural delivery that, when medically necessary, offer benefits to the fetus without increasing mortality risks for the mother. But, if women are reporting coercive pressures from their physicians to undergo this procedure, then questions about their justification will persist.

 

For More information on this subject, please refer to:

http://www.theatlantic.com/health/archive/2014/04/why-most-brazilian-women-get-c-sections/360589/

http://www.mhtf.org/tag/cesarean-section/

http://www.huffingtonpost.com/2014/04/16/c-section-rates_n_5161162.html?&ir=Healthy+Living&ncid=tweetlnkushpmg00000033

http://www.theguardian.com/commentisfree/2014/apr/10/natural-birth-c-section-choice-brazil-forced-pregnancy

http://www.telegraph.co.uk/women/mother-tongue/10767161/Kidnapped-by-the-authorities-meet-the-woman-forced-to-have-a-caesarean.html

http://ajcn.nutrition.org/content/95/2/465.full

http://www.ncbi.nlm.nih.gov/pubmed/24778358

http://www.sciedu.ca/journal/index.php/jha/article/view/3867/2690

http://www.vbac.com/how-does-a-cesarean-affect-the-baby/

http://www.hmhb.org/virtual-library/interviews-with-experts/cesarean-section-c-section/


Thanks for sharing !


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