HEALTH: Soaps Boost Brazilian Campaign for Natural Childbirth

By Fabiana Frayssinet Reprint | | Print |

Fabiana Frayssinet

RIO DE JANEIRO, Dec 4 1997 (IPS) - TV viewers of a Brazilian soap opera recently watched with fascination as one of the star’s of the show calmly gave birth to a child without any of the usual scenes of hysteria and desperation, so common on the small screen.

The scene from the soap opera “Por Amor (For Love)” – a show with one of the largest audiences of the Globo Television Network – was one of the highlights of a new campaign sponsored by the Federal Council of Medicine to promote natural; childbirth in Brazil.

In this country, 35 percent of births are by Cesarean section, although in some private clinics for the middle and upper classes, this percentage can be as high as 70 percent.

“We know that there has been an increase in the rate of ‘C’ sections all over the world; but in Brazil the number has exceded all acceptable figures. In fact we appear to be the world champions when it comes to cesarean sections, ” said the president of the Brazilian Federation of Obstetrics, Hildoberto Carneiro.

With the slogan “Normal birth is natural birth,” the campaign seeks to reduce the number of surgical interventions to at least 20 or 25 percent. But the campaigners have to overcome fears and prejudice among many mothers and mothers-to-be.

“I had my son through ‘C’ section because my friends and relatives suffered a lot with natural births. Many of them suffered the whole night, so I was scared to death,” says Monica, a 39-years- old mother.

Eight of 10 other women questioned randomly in a middle-class neighborhood in Rio de Janeiro, gave similar answers. They offered all kinds of medical explanations to justify the need for Cesarean section but, according to Carneiro, those arguments are only masked a fear of pain.

Soap operas, consumed in Brazil by millions of women, have not done much to attenuate those fears. That is why the current campaign – – which is being disseminated through the media – includes testimonies of well-known actresses, like Mal Madar, who this year had a baby through natural childbirth.

“Fiction always associates extreme suffering with women giving birth, she says. “it’s been the same on TV and in the movies; women having babies through natural childbirth always were shown screaming and in great pain and screaming, but that is now a thing of the past.”

Fear of pain has also been stimulated by the insufficient development of anesthesia in normal births that take place in hospital, which serve the poor sectors, explained Carneiro. In the case of private clinics, the phenomenon has increased due to “C sections on demand.”

“Patients tell their doctors that they want a Cesarean section, and the doctors – perhaps because they do not know how to say no, or because they do not want to lose their patients, or simply because they do not want to become emotionally involved with their patients’ fears – concede, even if it isn’t necessary,” said the physician.

Another factor is doctors’ fears of the risks involved in natural childbirth in Brazil. Thirty percent of lawsuits in the health sector in Brazil involve obstetricians. The low salaries of medical service personnel also justifies the increase in ‘C’ sections.

“It’s not that doctors make more money with an operation, but it can be scheduled at their convenience and it doesn’t disrupt their private practice. They don’t have to leave their offices or other jobs in a hurry to attend a birth,” says Carneiro.

Besides delaying contact between mother and child because of the care needed after the operation, a Cesrean section requires seven to 10 days of recovery, while a natural birth takes three. Risks are also higher, as with all surgical interventions.

But doctors say that the campaign does not seek to reduce the number of prescription ‘C’ sections, required in cases of irregular position, lack of oxygen to the fetus, arterial hypertension in the mother, or disproportion between the fetus and the birth canal.

“Cesrean sections are sometimes the only way to save the life of mother and child. We do not mean to underestimate the operation. ‘C’ sections are fine; but they must not be abused, or performed without a medical reason,” Carneiro concluded.