Increase in cesarean sections in Brazil – a call to reflection

Braga, Antonio Celso de Oliveira; Sun, Sue Yazaki; Zaconeta, Alberto Moreno; Trapani, Alberto; Luz, Adriana Gomes; Osanan, Gabriel Costa; Duarte, Geraldo; Ramos, José Geraldo Lopes; Wender, Maria Celeste Osório; Nomura, Roseli Mieko Yamamoto; Francisco, Rossana Pulcineli Vieira; Borges, Vera; Mattar, Rosiane

doi:10.1055/s-0043-1768454

Cited by 4 publications

(1 citation statement)

References 9 publications

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“…Studies suggest that the CDMR contributes to an increase in the caesarean section rate in general and in Brazil, where there is a culture of caesarean sections, this tendency is stronger, in addition to the cases of those who, in the absence of a maternal or fetal indication, take advantage of the caesarean section to carry out surgical sterilization. In Brazil, this type of surgery used to be restricted to the moment of childbirth, but has recently been legalized during delivery [ 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

Caesarean delivery on maternal request: the perspective of the postpartum women

Muhandule,

Benetti,

Fogulin

et al. 2024

BMC Pregnancy Childbirth

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Background Caesarean delivery on maternal request (CDMR) is an increasing delivery option among women. As such, we aimed to understand the reasons that led pregnant women to request a caesarean delivery. Methods A phenomenological study was conducted with semi-structured interviews, in a convenience sample, for women who had undergone a CDMR between March and June 2023, in a public reference university hospital in Campinas, Brazil. The interviews were recorded, transcribed and subjected to thematic analysis, supported by Nvivo®, and Reshape®. Results We interviewed eighteen women between 21 and 43 years of age. The reasons for C-section as their choice were: 1) fear of labour pain, 2) fear for safety due to maternal or fetal risks, 3) traumatic previous birth experiences of the patient, family or friends 4) sense of control, and 5) lack of knowledge about the risks and benefits of C-section. Conclusions The perception of C-section as the painless and safest way to give birth, the movement of giving voice and respecting the autonomy of pregnant women, as well as the national regulation, contribute to the increased rates of surgical abdominal delivery under request. Cultural change concerning childbirth and better counseling could support a more adequate informed decision-making about delivery mode.

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Section: Introductionmentioning

confidence: 99%

Caesarean delivery on maternal request: the perspective of the postpartum women

Muhandule,

Benetti,

Fogulin

et al. 2024

BMC Pregnancy Childbirth

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Effect of the COVID-19 pandemic on maternal mortality and cesarean section rates among brazilian adolescents

dos Santos Borges,

Suzart,

Lipi

et al. 2024

International Journal of Adolescence and Youth

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Cesarean section rates according to the Robson Classification and its association with adequacy levels of prenatal care: a cross-sectional hospital-based study in Brazil

Piva,

Voget,

Nucci

2023

BMC Pregnancy Childbirth

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Background The rate of Cesarean section (CS) deliveries has been increasing worldwide for decades. Brazil exhibits high rates of patient-requested CS deliveries. Prenatal care is essential for reducing and preventing maternal and child morbidity and mortality, ensuring women's health and well-being. The aim of this study was to verify the association between the level of prenatal care, as measured by the Kotelchuck (APNCU – Adequacy of the prenatal care utilization) index and CS rates. Methods We conducted a cross-sectional study based on data from routine hospital digital records and federal public health system databases (2014–2017). We performed descriptive analyses, prepared Robson Classification Report tables, and estimated the CS rate for the relevant Robson groups across distinct levels of prenatal care. Our analysis also considered the payment source for each childbirth – either public healthcare or private health insurers – and maternal sociodemographic data. Results CS rate by level of access to prenatal care was 80.0% for no care, 45.2% for inadequate, 44.2% for intermediate, 43.0% for adequate, and 50.5% for the adequate plus category. No statistically significant associations were found between the adequacy of prenatal care and the rate of cesarean sections in any of the most relevant Robson groups, across both public (n = 7,359) and private healthcare (n = 1,551) deliveries. Conclusion Access to prenatal care, according to the trimester in which prenatal care was initiated and the number of prenatal visits, was not associated with the cesarean section rate, suggesting that factors that assess the quality of prenatal care, not simply adequacy of access, should be investigated.

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Increase in cesarean sections in Brazil – a call to reflection

Cited by 4 publications

References 9 publications

Caesarean delivery on maternal request: the perspective of the postpartum women

Caesarean delivery on maternal request: the perspective of the postpartum women

Effect of the COVID-19 pandemic on maternal mortality and cesarean section rates among brazilian adolescents

Cesarean section rates according to the Robson Classification and its association with adequacy levels of prenatal care: a cross-sectional hospital-based study in Brazil

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