99% C-section Rate in Brazil

Birth has become overly medicalized in Brazil.

Sure, that is a true statement for almost any country in the world. As we look at the rates of unnecessary interventions and abuse of technology, from cesareans to inductions to institutional violence, we have begun to ask ourselves what we can do to change this reality.

It is my hope that in sharing the birth practices of Brazil others may put this information to good use, consciously asking questions and adapting strategies that work to the needs of their communities. Let us remember that cultural beliefs and myths play a big part in maternal and perinatal health.

Brazil is a country of women who live in diverse birth realities. Although it is accepted as a fact that 99% of pregnant women receive care in hospital, this is not true. Women in the poorest and most remote areas of the North, Northeast and Amazon Rainforest areas of Brazil may have to travel great distances to get to a hospital. Thus, in these areas due to this and local cultural women are still largely attended by Traditional Midwives at home.

Now, in the large metropolitan cities women do have easir acess to hospitals. The care in maternity hospitals is largely medicalized. A large number of births are c-sections (some hospitals rate up to 99%), the births that do end up being vaginal are most likely to include a cascade of rotine interventions from oxytocin (pitocin), shaving of the pubic area, epidural anesthesia, forceps, episiotomy and mother-baby seperation.

Privade Hospitals X Public Hospitals
Brazil is a country divided by social and economical disparity. Brazil is one of the world champions of cesarean rates, maintaing a national rate of around 40% c-section. That´s bad but not that bad, one might think, many other countries are showing similarly high rates. Then we see what the numbers really say.

Women who give birth in Public, government-funded, hospitals face a 37% c-section rate.

Women who give birth in Private, either by private insurance or out-of-pocket payment, face an 80% c-section rate.

In my personal experience through researching birth practices throughout the country I have heard of many hospitals with 99% c-section rates. People ask me how that´s possible, the answer is simple:

Women have scheduled cesareans before they ever get a chance to go into labor and possibly have a vaginal birth.

This happens usually around 38 weeks, which has been linked to the rise in prematurity, since some babies may not be "ready" to be born at the time of the c-section. It is also common for women to be told by their ob/gyn to chose the date for their c-section during their 1st pre-natal visit based solely on their due date.

This post is long, to be continued soon....