Specialists advocate normal births and fewer cesareans

Heading the list of nations with the highest cesarean section rate, Brazil needs to put an end to violence during childbirth, so that pregnant women are no longer scared of giving birth naturally. In order to meet this goal, training programs for health professionals should be made swifter and mothers provided with all proper conditions for giving birth comfortably. This is the judgment expressed by obstetricians meeting today (Sep 13) and tomorrow in Rio de Janeiro for an international conference.

Researcher at Oswaldo Cruz Foundation (Fiocruz) Maria do Carmo Leal mentions a survey entitled Naissance: a Nation-wide Inquiry on Birth and Conception (Pesquisa Nascer, in the original Portuguese), in an attempt to name a number of factors leading to the country's 56% cesarean section rate, against a global average of 18%. The study reveals that pregnant women in Brazil are not allowed to walk and eat in order to ease contractions, are given Oxytocin (a synthetic hormone) to speed up labor and undergo procedures like episiotomy (a vaginal incision for dilatation) and the artificial breaking of the water. “These things happen without any anesthetics, as women suffer terribly, in such a way that they obviously dread normal births,” the researcher argued.

Between 2011 and 2012, Maria do Carmo Leal coordinated the study, which surveyed 23 thousand women throughout Brazil. In her view, women are subjected to “the worst situation possible” when giving birth. “They lie down, and, despite federal law, many hospitals—public as well as private—do not grant entry to an extra person. In other words, Brazil hasn't encouraged good births,” she stressed.

The survey, which covers both women and babies, also disclosed that, early in the pregnancy period, six in every ten women prefer to give birth by natural means. This opinion changes as the pregnancy advances, especially towards labor, because of the violence, says obstetrics nurse Heloisa Lessa, who holds a doctorate degree in the field.

Maria do Carmo and Heloísa Lessa further noted that among the advantages of normal birth are the reduction in the number of deaths among women as well as hemorrhagic and infection-related complications. As for the babies, the amount of stillbirths is also seen to plunge, along with problems like asthma and child obesity.

Experts believe that women are more aware of the benefits of normal birth, and have presented their demands to the Ministry of Health. In her opinion, the next step is to urge both private and public healthcare systems to offer the conditions for women to have normal births at home. She also argues for more birth houses—of which only one is in operation in Rio de Janeiro.

Translated by Fabrício Ferreira