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Brazil's New Rules to Limit C-Sections

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The Western Hemisphere has the highest C-section rate in the world; Brazil wants to change that.

On Monday, Brazil introduced new rules aimed at curbing the country’s unusually high rate of caesarean sections. The rules will require doctors to inform women about the risks of C-sections and ask them to sign a consent form prior to the procedure. Doctors will also have to sign a form justifying the C-section.

This is not the first time that the Brazilian government has sought to decrease the country’s high caesarean birth rates. For years, Brazil’s federal government has been promoting the benefits of natural childbirth through various programs and legislation. A 2005 law even guarantees women the right to give birth naturally if they so choose, though it is not usually respected. 

Yet Brazil is not alone in the region in dealing with high levels of caesarean births. In fact, the Western Hemisphere has the highest rate of C-section operations in the world. The World Health Organization claims that the ideal rate for caesarean sections is between 10 and 15 percent. The rate in the Americas was about 38 percent last year, with particularly high rates in Brazil, Mexico, the United States, Argentina, and the Dominican Republic.

“It´s very worrisome that almost four out of every 10 births in the region are by C-section," said Suzanne Serruya, director of the Latin American Center for Perinatology, Women, and Reproductive Health of the Pan American Health Organization. "Doctors, midwives, obstetric nurses, those responsible for health policies, mothers and fathers, and society as a whole should work together to reduce this number and use caesarean sections only when it´s needed for medical reasons."

The causes of the region’s high rates of C-sections are varied, from medical expediency to questions of attitude. In Brazil, C-sections are deeply ingrained in the culture. "In our culture, childbirth is something that is primitive, ugly, nasty, inconvenient," Dr. Simone Diniz from the University of São Paulo told The Guardian. "It is something poor women are supposed to endure."

In the U.S., casual attitudes about surgery and limited awareness of the risks of cesarean sections contribute to the country’s high cesarean rate. In Mexico, most doctors prefer C-sections because they can be easily scheduled and quickly executed. Lack of hospital beds for natural births is another important factor for mothers-to-be in Mexico.

With so many factors involved, reversing the region’s high caesarean section rate will not be easy. It remains to be seen whether legislation like Brazil's can have a lasting impact.

Any opinions expressed in this piece do not necessarily reflect those of Americas Quarterly or its publishers.
Tags: Brazil, women's health, Latin America

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