Great Caesarean epidemic in Brazil is to be stopped

In Brazil, a questionable trend in births prevailed: More than every second woman gives birth to her child by means of a planned caesarean section. Although there is no medical need, expectant mothers often choose this option for fear of the pain of natural delivery. Many do not realize that they are taking health risks. Following a haunting appeal from the World Health Organization (WHO), the country now wants to get a grip on the "caesarean section epidemic" with new regulations and targeted measures.

Number of medically unnecessary caesarean sections is increasing worldwide
Many women are so afraid of labor and the birth process that they decide against a natural birth. They give birth to their child at a pre-determined appointment in the operating theater by caesarean section. While in Germany most children are still born naturally, in countries like Brazil with 55.6 percent of births or the Dominican Republic prevails with 56.4 percent percent of the proportion of cesarean delivery births. According to the WHO, the number of non-medically necessary caesarean sections is increasing worldwide.

In Germany, according to the WHO figures, two-thirds of the births are natural, with about one-third of the children being born by caesarean section (2013: 31.8 percent). However, the WHO recommends a Caesarean rate of no more than 10 to 15 percent. Because the surgical intervention involves risks for mother and child. This can lead to high blood loss and other organs in the abdomen of the woman, such as the bladder or the intestine, are injured. The child may also suffer slight scabs or cuts from the procedure.

Other arguments speak in favor of natural childbirth: normal birth is also increased by the concentration of stress hormones in the child's blood, which are important for adapting the circulation to the world outside the womb. By the pressing process at the natural birth also the amniotic fluid is pressed out of the lungs of the babies. After cesarean delivery, children sometimes need artificial respiration.

According to the Brazilian Ministry of Health, the intervention increases the risk of respiratory disease in babies by up to 120 percent. The risk of the mother dying at birth is three times greater. "Because of all the risks associated with each operation, it should always be the exception," said Brazilian WHO expert Suzanne Serruya to the dpa news agency. "Cesarean sections can save lives. But it is scientifically undisputed that the birth should be normal. "

Many WHO natural birth guidelines are not respected in Brazil
However, to stop the "caesarean section epidemic" mentioned in the Brazilian media, something has to change fundamentally. "Natural delivery is particularly painful and risky in Brazil," reports Carmen Simone Diniz, the coordinator of the 2014 study "Nascer no Brasil," in an interview with the news agency. According to Diniz, many WHO guidelines for births in Brazil would not be adopted. Women should not decide for themselves in which position they want to give birth to their child. In addition, it is customary to administer to the mothers-to-be the labor-promoting hormone oxytocin, which, however, intensifies the pain. The Caesarean section would thereby become "salvation".

Serruya also criticizes that pregnant women are often not informed about the risks of caesarean section. They often have prejudices against natural deliveries. The caesarean section is therefore in Brazil a "problem of the public health system", but also a "cultural issue".

Brazil wants to improve obstetrics
Also financial interests of doctors and clinics can be a reason for the lack of education of the Schwangen. Because a caesarean section is more lucrative than a natural delivery, reports Etelvino Trindade, president of the Brazilian Association of Gynecology and Obstetrics, told the news agency. With fixed cesarean appointments, which are usually fixed long in advance, the hospital occupancy can be better planned. "You can only do that with a caesarean section". In the long term, however, the high number of interventions causes high costs for health care and the state.

Brazil now wants to counteract the questionable trend of birth with new regulations and targeted measures. For example, Brazilian Health Minister Arthur Chioro reported on a pilot project involving more than two dozen hospitals to improve overall obstetric care. From June, the health insurance companies will also have to inform their insured persons about the proportion of cesarean births performed by doctors and hospitals. One hopes thereby to take the pregnant woman the fear of a natural birth. (Ag)