Brazil health officials concerned over cesarean birth ‘epidemic’

Cesarean section births, where a baby is delivered through an incision in the abdomen instead of vaginally, are sometimes necessary for the health and well-being of mother and child.

In fact, the World Health Organization (WHO) indicates approximately 15 percent of deliveries require this form of medical intervention.

SEE ALSO: Cesarean delivery linked to childhood obesity

In Brazil, however, the numbers are astonishingly different.

The World Bulletin reports 84.6 percent of babies born in the country are born through cesarean section. Much of this has to do with the culture surrounding birth in Brazil; many people see cesarean births as a way to make pregnancy convenient, and medical schools in the nation are teaching this form of delivery is ideal. With both patients and doctors pushing cesarean deliveries, it’s no wonder the rate has skyrocketed in the Latin American country.

“The epidemic of cesarean sections that we see in our country is unacceptable, and we have no option other than to treat it as a serious public health issue,” Health Minister Arthur Chioro said in a public statement. “We cannot … consider cesarean sections as normal births.”

Unfortunately, even women who do want natural births are being pressured to have a cesarean performed. Maria Luiza Guimarães explained she had all five children through cesarean and cost had a lot to do with her decision.

“I more or less begged to have a natural birth, but the doctor convinced me having a C-section was the best option, safety-wise,” she said. “One doctor we saw, but didn’t proceed with, said a natural birth would cost twice as much as a cesarean ? $6,880 (18,000 reais) instead of $6,440 (9,000 reais) ? because his team would be kept on standby, unlike with a planned C-section. Even now I don’t know whether any of my C-sections were really necessary.”

Medically unnecessary cesarean births are anything but safer than vaginal delivery, caution experts. According to the American Pregnancy Association, there are significant risks to both the mother and child with this procedure?risks that are unnecessary if the baby could be birthed naturally.

Mothers who have a cesarean are at risk for infection, increased blood loss, injury to other organs, scar tissue buildup, prolonged recovery time, multiple surgical procedures (to repair damage from the cesarean), and difficulty bonding with their infant. What’s more, the risk for maternal fatality is higher with a cesarean delivery compared to a vaginal one.

The risks to the infant are also hefty. Babies born from cesarean section lack the stimulation they would have received passing through the birthing canal. This can lead to respiratory issues and fetal distress, a complication of anesthesia in the child’s system.

Babies born from cesarean also run the risk of being injured by surgical tools or being removed from the womb too early; just because a child’s due-date is up doesn’t mean the baby is ready to be born.

To combat the number of infants born cesarean in Brazil, health officials are placing new rules and restrictions on physicians who perform the procedure. Doctors will not have to submit justification as to why the procedure was performed or they will not receive payment. Providers will also be required to inform mothers of the risks associated with a cesarean birth, and facilities that do not pass on such information will face a fine.

SEE ALSO: Why Brazilian women choose natural birth over cesarean

“Much lower C-section rates and been successful at least with hospitals that are paid on a contract basis,” explained Ana Maria Malik, professor of health at the Fundação Getúlio Vargas. “Health officials have now set some quality indicators, including C-section rates, to be achieved by third party payers and this will include financial rewards — or sanctions — for the providers.”

The new rules will allow Brazilian government officials to monitor the number of cesarean births over the next few years. Time will tell if holding doctors more accountable for their procedure choices will have an effect in reducing the high usage rate of cesarean birth.

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