The birth rate by caesarean section exceeds 57% for the first time in the country; the percentage considered adequate by the WHO goes up to 15%
After a brief period of decline, the caesarean section rate has picked up again in the country and broke a record in 2020, when 57.2 percent of births were through caesarean deliveries — the highest rate in history, according to an analysis conducted by the Institute Stage on the basis of data from the Information System on Born Live (Sinasc), del Ministry of Health.
The previous record was set in 2014, when the rate was 57%. In the following year, with the growing movement for I leave humanized, the country experienced an increase in the normal birth rate for the first time in decades. As a result, the rate of caesarean sections dropped to 55.5% in 2015.
The downward scenario continued in 2016, but in 2017 the trend changed again and the caesarean rate returned to growth year after year, culminating in the record high in 2020 and maintaining the rate around 57% in 2021, the latest data available (see graph). Preliminary data for 2022, updated in October, show a rate of 57.6%, which could lead to a new record if the index is confirmed.
Although caesarean section is an important technique to save the pregnant woman and the fetus in some circumstances, its indiscriminate use without clinical indication is considered a public health problem because it increases the risk of complications for the woman and the child. “There is an increased risk of bleeding and infection, as well as complications related to the placenta,” says obstetrician Adriana Gomes Luz, secretary of the National Commission specialized in prenatal care of the Brazilian Federation of Gynecological and Obstetrics Associations (Febrasgo) and assistant professor at the State University of Campinas (Unicamp).
Cesarean sections performed without an indication also increase the risk that the baby will be born before its development is completed in the mother’s uterus. THE World Health Organization (WHO) believes that the appropriate caesarean delivery rate is between 10% and 15%.
According to the Pan American Health Organization (OPAS), Brazil is one of the five countries in the world where the rate of caesarean sections exceeds that of vaginal deliveries: Egypt, Cyprus, Turkey and the Dominican Republic are also in this situation. With the record rate recorded in 2020, Brazil is approaching the 58.1% achieved by the Caribbean country, the world leader in caesarean sections.
The pandemic has impacted care for pregnant women, say experts
For the experts, the effects of the pandemic on the entire health system explain, in part, the record rate of caesarean sections in Brazilbut also the lack of more incisive actions and campaigns has contributed to slowing down the progress that was beginning to be observed in 2015 in the appreciation of vaginal birth.
“During the pandemic, many maternity hospitals have limited access to female partners, who are important at the time of labour. This has created insecurity among pregnant women, they wanted to leave that environment as quickly as possible. We have seen an increase in the number of requests by cesarean section,” says Adriana.
He says that the same health emergency, with efforts directed at treating coronavirus patients, has also had an impact on maternal and child health services. “There has been a disorganization of the health system as a whole because it was necessary to shift attention to covid-19. Some normal delivery rooms have been transformed into covid areas”, she says.
For Rômulo Negrini, medical coordinator of the maternity hospital of the Albert Einstein Israelite Hospital, the impact of the pandemic is felt right from prenatal care, which also weighs on the choice of childbirth. “Many women have missed prenatal appointments due to the pandemic. And it is along this path that the team and the pregnant woman discuss the birth,” he says. He also says that because some pregnant women have been infected with the coronavirus and experienced complications, there may have been an increased need for C-sections.
Even some specific projects for the enhancement and training of those born normal have had to be suspended due to the covid-19. “In the project Parto Adequado (initiative of the National Integrative Health Agency in collaboration with Einstein to provide information to hospitals and operators in the country on childbirth), face-to-face learning sessions were held for healthcare professionals and these had to be suspended. People who were actively working in normal birth actions were displaced to help fight the pandemic,” Negrini says.
In addition to the impacts of the pandemic, Adriana believes the topic needs to be the focus of multiple policies and campaigns so that reducing unnecessary C-sections is consistent. “When we bring this topic up for discussion and adequately show the pros and cons of a caesarean section, with celebrities and influencers embracing the cause, the population watches and reflects,” says the midwife.
For her, one of the most important actions is the literacy of the patient about the types of delivery and their rights. “We must empower women so that they do not passively accept caesarean section when there is no clear indication. And also dispel myths, such as the problem of pain in normal childbirth. Today we have pharmacological and non-pharmacological techniques to relieve discomfort,” she says the doctor .
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Source: Terra
Ben Stock is a lifestyle journalist and author at Gossipify. He writes about topics such as health, wellness, travel, food and home decor. He provides practical advice and inspiration to improve well-being, keeps readers up to date with latest lifestyle news and trends, known for his engaging writing style, in-depth analysis and unique perspectives.
