Cesarean section in Brazil

Janowitz, Barbara; Nakamura, Milton S.; Lins, Fernando Estellita; Brown, Michael L.; Clopton, Deborah

doi:10.1016/0277-9536(82)90419-1

Cited by 37 publications

(19 citation statements)

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“…Young women were more prone to cesareans than adolescents, suggesting that age is an independent predictor of type of delivery, in agreement with other Brazilian authors 11,21,22 who reported a similar association. In our study, the effect of age was partially explained by cervical dilatation at admission and use of oxytocin, indicating that both the stage of labor and its management may reduce the effect of age on the odds of cesarean.…”

Section: Discussionsupporting

confidence: 92%

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Factors associated with cesarean sections in a public hospital in Rio de Janeiro, Brazil

et al. 2006

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Brazil has one of the world's highest cesarean section rates. Contributing factors include the organization of obstetric practice, physicians' attitudes, and women's preferences and decisions. This study aimed to identify factors associated with cesarean sections in a public maternity hospital in Rio de Janeiro. A case-control study was conducted with 231 cesarean sections (cases) and 230 vaginal deliveries (controls). Hierarchical logistic regression analysis was performed, based on a conceptual model. Factors associated with increased odds of cesarean section were: primiparity; mother's age 20-34; last birth by cesarean; cervical dilatation < 3cm at admission; patient request; daytime birth; male attending obstetrician; obstetrician on duty for more than 24 hours a week; obstetrician with private practice; gestational hypertension; non-cephalic presentation; and gestational age > 41 weeks. Factors associated with lower odds of cesarean were: gestational age < 37 weeks; leaving home with signs of labor, use of oxytocin; and amniotomy. In this hospital, interventions aimed to modify the above-mentioned factors can help lower the cesarean rate.

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Section: Discussionsupporting

confidence: 92%

“…However, obstetric history strongly influenced type of delivery. The association between primiparity and cesarean section was also found in Brazil by Janowitz et al 21 and Barros et al 23 . According to Freitas 11 (p. 154), the majority of obstetricians "considered primiparae less capable of dealing with the difficulties of labor".…”

Section: Discussionsupporting

confidence: 62%

Factors associated with cesarean sections in a public hospital in Rio de Janeiro, Brazil

et al. 2006

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“…During the last decades, it was noticed that in many countries of the world a raise in the percent of cesarean sections over natural birth [2,5,6]. The cesarean section rates reach 26% in the United States; 21.3% in England; 23.9% in North Ireland and 19% in Canada [7].…”

Section: Introductionmentioning

confidence: 99%

Obstetricians and pregnant women from Formiga’s town, in Minas Gerais State, Brazil. Deciding what kind of labor to be held

Silva¹,

Costa²,

Herculano³

2013

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The decision of what kind of labor that should be held is intermittently generating a great debate in Brazil. The growth in the number of cesarean sections has raised worries in some of the involved sectors of the society. It was proposed to investigate the factors which lead the women to take this decision, trying to understand the principle involved. A bibliographic review about the subject was made. The research happened in the town of Formiga, where some data were collected in two hospitals-public and private -about the number of labors during two months. Subsequently, the obstetricians and a group of pregnant women were submitted to a questionnaire, the answers were compiled and transformed into graphs which were analyzed. Finally, the data were compared with the related literature. The number of cesarean sections in the town was above the standard recommended. According to the obstetricians, the main reason would be the preference of the pregnant women, fact which was not confirmed by them, that discrepancy was confirmed by the literature. The level of information about the clinical indications for the type of labor was considered satisfactory by the doctors and the pregnant women, data contestable by the academics. The fear and the pain were identified by obstetricians and pregnant women as a predominant factor for the preference of cesarean sections, provided that, according to the literature, shows the precariousness of information for pregnant women about the normal birth. Another important data is that the doctors can have an important role in the kind of labor to be made. According to the obstetricians, their role would be very limited, but according to some pregnant women, they did trust in the doctors which should be the ideal labor for them. The analysis of most of the data collected shows a discrepancy between the information of pregnant women and obstetricians. Both sides involved in the issue do not admit as responsible for the elevate number of cesarean sections, so, some new approaches are needed for analysis. This analysis and diagnosis indicate the next step of the research: the supervision of the pregnant women, since the beginning of the gestation until the birth, trying to figure out the real factors which lead them to decide what kind of delivery should be taken.

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“…No Brasil, onde cerca de um terço dos partos ocorre por cesarianas, também verificou-se esta tendência 3 . Apesar de que proporções aceitáveis ainda não tenham sido definidas, considera-se bastante alto este índice, comparado com outros países 10,17 . A comparação dos estudos que relataram um risco aumentado de problemas na lactação entre mães submetidas a cesarianas 4,7,11,22,23,26,27,29,31,34,37 com os que não mostraram estes resultados 2,12,15,16,18,21,32,33,39 é dificultada pelas diferentes metodologias empregadas, por vezes inadequadas ou insuficientemente descritas.…”

Section: Introductionunclassified

Incidência e duração da amamentação conforme o tipo de parto: estudo longitudinal no Sul do Brasil

et al. 1998

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OBJETIVO: Comparar a incidência de amamentação conforme o tipo de parto. MATERIAL E MÉTODO: Estudo de coorte prospectivo de base populacional com 655 crianças brasileiras nascidas no ano de 1993 e acompanhadas durante o primeiro trimestre de vida, através de duas visitas domiciliares. RESULTADOS: A duração da amamentação foi similar entre os nascidos por parto vaginal e cesariana emergencial. Os nascidos por cesariana eletiva apresentaram um risco três vezes maior de interromper a lactação no primeiro mês de vida, após controle de fatores de confusão (razão de odds=3,09; 95% IC 1,3-7,2). Este aumento de risco não persitiu até o terceiro mês de vida. CONCLUSÕES: Recomenda-se aos serviços de saúde atenção especial a lactantes submetidas a cesarianas eletivas, para que seja promovido o aleitamento desde as primeiras semanas, evitando a interrupção precoce.

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Cesarean section in Brazil

Cited by 37 publications

References 1 publication

Factors associated with cesarean sections in a public hospital in Rio de Janeiro, Brazil

Factors associated with cesarean sections in a public hospital in Rio de Janeiro, Brazil

Obstetricians and pregnant women from Formiga’s town, in Minas Gerais State, Brazil. Deciding what kind of labor to be held

Incidência e duração da amamentação conforme o tipo de parto: estudo longitudinal no Sul do Brasil

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