Concerned about the high Cesarian section rates in the private healthcare sector (84%) and looking for more humane childbirth experiences, pregnant Brazilian women have increasingly turned to the public healthcare
system for delivery. They have been increasingly likelier to chose to have their babies at referral hospitals which provide care under the public, free of charge Unified Health System [SUS] and rely on complete medical staff.
Such is the case with Camille Ramalho, 33, who gave birth at Maria Amélia, a public local maternity in downtown Rio. “I have used my private health insurance coverage for all prenatal care, but turned to SUS to deliver my baby,” she said, noting that she made an informed choice. “I read a lot, I talked to a lot of moms, and I’m glad with the way it turned out.”
Nurse-midwife Heloisa Lessa reports demand at Maria Amélia has been on the rise in Rio. She says “many doctors still have a preference for C-sections, because they can be planned ahead and are better paid for by health insurance providers,” unlike in public health centers. Now with new policies encouraging women to prefer vaginal delivery over Cesarian sections, they have become increasingly more inclined to avoid the risks involved in unnecessary C-sections.
Although there are no estimates as to how many pregnant women with private health insurance coverages have chosen to have their babies at the public health system, the local health secretariat reports the rate of natural births at Maria Amélia reaches 76.2% – above the average 66% at the local public network, which includes another nine maternity hospitals and a birthing center.
Hiring “doulas” – professional midwifes who provide care to women from the onset of pregnancy, and even parenting advice to the couple – is also becoming an increasingly popular practice in Rio. Eva Holzova, a 32-year-old translator, says the “doula” has helped her give birth to her younger daughter by vaginal delivery, after a cesarean section for Eva’s first child. “She taught me some exercises and provided guidance on childbirth phases, which was a crucial emotional support,” she said.
In cases of low-risk pregnancy, vaginal delivery is the ideal choice, with medical staff trained to keep invasive intervention on the patient’s body to a minimum, advises Silvana Granato, a researcher at Oswaldo Cruz Foundation. Among the advantages of normal delivery are lower mortality rates and lower risk of post-operative pain for mothers. In babies, stillbirth risk is reduced, as well as the risk of respiratory complications and child obesity.
In order to encourage natural births, Rio state government have provided related training for healthcare staff and even recently bought a bath tub for a hospital, since warm water immersion eases birth labor.
Translated by Mayra Borges