Published On: January 11, 2015

Cesarean Birth Epidemic

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Brazil has unveiled new rules aimed at stemming the nation’s “epidemic of cesareans” and promoting natural births among private health care providers. It is believed that the epidemic is due to women not wanting permanent changes to their sex lives as well as doctors promoting cesareans over natural deliveries.

Health Minister Arthur Chioro called Brazil’s obsession with cesareans (also known as C-sections), which account for more than eight out of 10 births handled by private health providers, a “health problem.”

According to Brazil’s National Health Agency (ANS), the national average in Brazil for cesarean births is 52 percent, with 84 percent of C-sections being conducted in private hospitals and paid for by private health insurance. While in state hospitals, 40 percent of deliveries are via C-section.

Health Minister Arthur Chioro

Health Minister Arthur Chioro

Brazil has had universal health care for many years; however, most middle class Brazilians maintain private health insurance policies because private coverage provides a much better quality of service in private hospitals than the state hospitals. “The epidemic of cesareans we see today in this country is unacceptable, and there is no other way to treat it than as a public health problem,” Chioro said. “What’s normal are normal births.”

In the United States, just over 32 percent of all births are cesareans, according to the Centers for Disease Control in Atlanta. Brazil’s national average of 52 percent is quadruple what the World Health Organization recommends for cesarean section delivery rates.cesarean-booklet-cover-210x272

There are numerous reports in the Brazilian press about unscrupulous doctors promoting C-sections in order to earn more money in health insurance payments. However, from now on, doctors must submit prenatal information on all births to the government, and they will no longer be allowed to schedule a C-section procedure before a pregnant woman has gone into labour. Doctors will also have to provide patients with information about the risks of performing a C-section.

According to an op-ed published in Folha de São Paulo, the lack of regulation amid an expanding health insurance market, together with the fact that not enough gynecologists and midwives are being trained in vaginal births, has led to the explosion of C-section births.

Cesareans multiply by 120 percent the risk of respiratory illnesses among infants and triple the risk of maternal mortality during childbirth. However, despite the risks, cesareans are widely seen in Brazil’s body-conscious, vain culture as easier, more comfortable, and less detrimental to mothers’ bodies.

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Additionally, some pregnant women prefer cesareans because it permits them to choose their child’s birth date to coincide with another family member’s birthday. Numerology and astrology also play a part in choosing birth dates.

Another reason for the large number of cesareans in Brazil is physicians often favor them for their predictability and ease of scheduling. Some expecting mothers have reported that while favoring a vaginal birth, they were encouraged by their doctors to have a cesarean, which is the opposite of most obstetricians’ guidance in the US.

Minister Chioro denounced the current status quo among Brazil’s middle class, saying, “There is no justification, [whether] financial, technical or scientific, that you can [argue for the] high rate of cesarean sections in health insurance. We cannot accept that cesareans be performed as a result of buying power or convenience.”

[This article was written in part by the Associated Press and also the UK edition of the International Business Times and was edited by CIE.]

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