The Cut Above" and "the Cut Below

The Abuse of Caesareans and Episiotomy in São Paulo, Brazil

Bibliographic Data

ID4771783
AuthorsSimone Grilo Diniz (Feminist Center for Studies and Advisory Services), Alessandra Sampaio Chacham (0000-0002-6651-9863, Pontifícia Universidade Católica de Minas Gerais)
Year2004
Volume12
Issue23
Pages100-110
Publication date2004-01-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueReproductive Health Matters (JOURNAL)
Journal identifiersISSN: 0968-8080 • E-ISSN: 1460-9576
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1016/s0968-8080(04)23112-3
PMID15242215
OpenAlexW1968314141
LanguageEN
Citations received49
References cited20

In the last 50 years, a rapid increase in the use of technology to start, augment, accelerate, regulate and monitor the process of birth has frequently led to the adoption of inadequate, unnecessary and sometimes dangerous interventions. Although research has shown that the least amount of interference compatible with safety is the paradigm to follow, vaginal birth is still being treated as if it carries a high risk to women's health and sexual life in Brazil. This paper describes the impact of the intervention model on women's birth experience, and discusses how the organisation of public and private maternity services in Brazil influences the quality of obstetric care. Brazil is known for high rates of unnecessary caesarean section ("the cut above"), performed in over two-thirds of births in the private sector, where 30% of women give birth. The 94.2% rate of episiotomy ("the cut below") in women who give birth vaginally, affecting the 70% of poor women using the public sector most, receives less attention. A change in the understanding of women's bodies is required before a change in the procedures themselves can be expected. Since 1993, inspired by campaigns against female genital mutilation, a national movement of providers, feminists and consumer groups has been promoting evidence-based care and humanisation of childbirth in Brazil, to reduce unnecessary surgical procedures

Caesarean section · Childbirth · Episiotomy · Gynecology · Obstetrics · Political science · Pregnancy · Private sector · Psychological intervention · Public sector · Female Genital Mutilation/Cutting Issues · Maternal and Perinatal Health Interventions · Medicine · Nursing · Ureteral procedures and complications