Scheduled Cesarean Sections in Brazil: Why so Many?

Joseph E. Potter, University of Texas at Austin
Kristine Hopkins, University of Texas at Austin
Ignez H.O. Perpétuo, Federal University of Minas Gerais
Anibal Faundes, Centro de Pesquisas Materno-Infantis de Campinas (CEMICAMP)

Brazil presents a high rate of cesarean section deliveries overall, and an astronomical rate (70%) in the private sector where one quarter of all births take place. The large majority (64%) of these procedures are scheduled in advance. The question that concerns us here is the motivation for scheduling cesarean deliveries in advance of spontaneous or induced labor, and the ethical considerations that doing so presents. While elective cesarean section may be scheduled for the convenience of either the woman, the physician, or both, serious medical and ethical reservations have been raised about this practice. And what if, as appears to be the case in Brazil, the woman really wants to deliver vaginally? In this paper, we present data from a prospective survey to assess the problematic medical practices that underlie scheduled cesareans in four metropolitan areas.