Emaline Reyes
Abstract
This article seeks to understand the causes of high cesarean section rates in Brazil (considered by many “The Cesarean Section Capital of the World”), and the reasons underlying the increase in what some scholars are deeming “elective” cesarean sections. In order to better understand the high cesarean section rate in Brazil I conducted a thorough literature review, with a special focus on cesarean sections that were occurring outside of “medical necessity.” Accompanying this review is a table I created in which I determine which articles are attributing cesarean section to maternal choice and which dispute this assertion. While rising cesarean section rates are often attributed to maternally elected cesarean sections, I found that the literature does not support this theory and that many women in Brazil not only do not elect cesarean sections but are often coerced into them. There was a distinct divide between the procedures performed in public clinics and private hospitals (which demonstrate a correlation to patient identity, economic status, and insurance coverage). Cesarean sections in Brazil are largely determined by a woman’s socioeconomic status, “race,” and ethnicity, rather than her preference or medical necessity. There is a long history of racism and reproductive control in Brazil, and the lack of informed consent and coerced obstetric procedures seen in Brazilian hospitals today shows us that these issues still persist. In order to ensure reproductive health and justice for all women, we must make sure that cesarean sections are only being performed when medically necessary and that they are not being overused in wealthy populations or underused in impoverished ones. Both coerced procedures and neglect to perform cesarean sections for those who need them serve to jeopardize maternal and infant health. These practices must be stopped, and resources and services must be more carefully distributed, so that we may improve the birth experiences and outcomes for women everywhere.
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