Could This Be the End of Elective C-Sections?
By Taylor Newman
In Brazil, a country notorious for its staggeringly high C-section rates - numbers in some private hospitals push 99% - protestors participated in a "Home Birth March" last month in the nation's state capitals: Belo Horizonte, Brasília, Curitiba, Florianópolis, Maceió, Porto Alegre, Recife, Rio de Janeiro, Salvador, São Paulo and Vitória. The protests followed public criticism levied against the coordinator of the obstetrics department at the Federal University of São Paulo, Dr. Jorge Kuhn, by the Regional Council of Medicine of Rio de Janeiro; Kuhn had recently defended home births, and childbirth in general as a pyshiological - rather than medical - process (kind of our headline here on Natural Parenting). The march, as a result, was held not only to support a woman's right to choose home birth as an option, but also to opt for a vaginal (rather than cesarean-by-default) delivery, as well.
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Although Kuhn's, and the protestors', endorsements of home birth prompted many of the same responsesthat mere mention of the topic generates here in the States - some people feel giving birth outside of a hospital at all is unsafe, and thus irresponsible - cultural fears around childbirth, in Brazil, go way back, and way beyond, even medicalized, mainstream conceptions of childbirth in America; as filmmaker and activist Ricki Lake shed light on, in her follow-up series to her groundbreaking documentary The Business of Being Born, Brazilian attitudes around childbirth compound into a clusterf*** (I'm paraphrasing) of a C-section epidemic. Extreme fear of the pain of childbirth is inherited, and pervasive, among Brazilian women, who also believe delivering vaginally will cause their bodies permanent harm. The medical system is set up so that private doctors must be on call for their clients around the clock; scheduling C-sections is the most obviously doable way for them to attend to all of those clients' births. And, Lake writes, "most of the current generation of obstetricians believe that cesarean delivery is safer than vaginal delivery and not only impart this philosophy to their patients but also refuse clients who are considering a vaginal birth." The Childbirth in Brasil organization, through its Obstetric Violence Experiment blog, has further highlighted problems in the doctor-patient relationship during childbirth, specifically the unbelievably common occurrence of doctor-to-patient verbal abuse… during labor. (Dang, that's cold.)
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It's no wonder some Brazilian women would prefer not to give birth in the nation's public, or private, hospitals. And although awareness is increasing in the Brazilian community around the risks C-sections pose to mothers and babies (C-sections are not at all safer than vaginal births; they significantly raise mortality stats), and the Committee of Brazilian Obstetrics 'officially' states that a natural, in-hospital birth is the most safe choice mothers can make, the majority of policy makers, doctors, insurance companies and moms-to-be in Brazil still run with a C-section-or-bust mentality that makes natural birth nearly impossible for those who desire it.
The protestors, along with an emerging population of Brazilian natural and home birth advocates, hope to change this. Check out the Home Birth March Facebook page if you want to get involved. (Here's Brazilian-born supermodel Gisel Bundchen's perspective on all of this, too, for your reading pleasure).
What do you think of the recent protests in Brazil? Do you think this kind of demonstration will be effective in shifting cultural attitudes? Will it affect public policy-making? Do we have any Brazilian readers in the house? What's your take?
