Brazil tightens rules to reduce caesarean sections

Caesareans account for nearly half of births in Brazil. Picture: Getty

The South American country has some of the highest proportion of caesarean sections of any country in the world, encompassing 85 per cent of all births in private hospitals and nearly half (45 per cent) in public hospitals.

Health minister, Arthur Chioro described the trend as an “epidemic,” accounting for more than half of births in a nation of 200 million people.

The World Health Organisation said the international healthcare community considers the “ideal rate” for caesarean sections to be somewhere between 10-15 per cent.

Under the new regulations, which came into force yesterday, doctors must inform women about the risks involved and ask them to sign a consent form before performing a caesarean.

The medics will also have to justify why a caesarean was necessary and fill in a comprehensive record of how the labour and birth developed and justify their treatment. Each pregnant woman will be assigned medical notes which record the history of her pregnancy, which she can take with her if she changes doctors. Doctors must also disclose information to patients including the number of caesarean sections they have carried out.

Jose Carlos de Souza Abrahao, director of the National Health Agency, regulatory agency linked to the ministry of health responsible for the health insurance industry, said: “Childbirth is one of the most important moments in the life of a woman and her family.

“By informing her of the risks that could come with an unnecessary surgical procedure, she will be more sure in her decision regarding the delivery, choosing what’s best for her health and for her baby’s health.”

Experts warn that caesarean sections may still be seen as the best way to deliver a baby due to a shortage of maternity beds and wards equipped to deal with natural births in the country.

There have been reports of some mothers-to-be who want to give birth naturally in a private hospital unable to find a bed because they have been reserved for scheduled deliveries.

Rosana Clein, a 37-year-old from Rio, planned to have her son born naturally but said that in the lead up his birth, she felt pressured to have a planned caesarean.

“I tried to find a doctor who was supposed to do a natural birth like this, but in Brazil it’s not so easy,” she explained. “They try to convince you the best way is to do a caesarean. They say you’re going to have a lot of pain the natural way.”

“For the doctor, it’s really easier to have the caesarean. You can book it and you have your agenda. It’s not a question of saying, ‘Go to the hospital now in the middle of the night.’”