Epidemic of caesarean sections in Brazil.
Brazil has one of the highest rates of caesarean section in the world. Patterns of caesarean sections were studied in a cohort of 5960 mothers followed from 1982 to 1986 in southern Brazil. Overall, 27.9% were delivered by caesarean section in 1982, this proportion being 30% for nulliparae, 80% for second deliveries when the first was by caesarean, and over 99% for third births when the first two were by caesarean. Socioeconomic status and requests for sterilisation by tubal ligation were important underlying factors. 9.4% of the women were sterilised during a caesarean section (3.7% in the lowest income group and 20.2% in the highest). 31% of women who had had their first child by a caesarean section and who were having a second operative delivery were sterilised. The high rates of caesarean sections and accompanying sterilisations reflect the lack of appropriate reproductive and contraceptive policies in the country.
Barros
F C
FC
Department of Social Medicine, Universidade Federal de Pelotas, Brazil.
Vaughan
J P
JP
Victora
C G
CG
Huttly
S R
SR
D001938:Brazil / Q000453:epidemiology; D002585:Cesarean Section / Q000706:statistics & numerical data*; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007182:Income; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D012086:Reoperation; D012307:Risk Factors; D013246:Sterilization, Tubal / Q000706:statistics & numerical data