Conflicts between Women's Intentions and Behaviors: Mode of Delivery in Brazil

Kristine Hopkins, University of Texas at Austin
Anibal Faundes, Universidade Estadual de Campinas
Ignez H.O. Perpétuo, Pontifícia Universidade Católica de Minas Gerais

In Brazil, the cesarean rate is high in the public sector (~30%) and astronomical in the private sector (>70%). However, since the large majority of women in both sectors say they prefer vaginal delivery, women’s delivery intentions are in conflict with this outcome. In the private sector, moreover, most cesareans are scheduled in advance. Our study sought to illuminate this apparent contradiction, and recruited pregnant women in four Brazilian cities, interviewing each three times: twice during pregnancy and again after birth. Interviews covered woman’s preferences about mode of delivery and the outcome of the delivery, including whether and why a cesarean was scheduled in advance. Our results indicate that the large majority of scheduled cesareans were not performed for a compelling medical justification. While some elective cesarean sections may be scheduled for the convenience of the woman, in Brazil it seems that the physicians’ interests are paramount and are often in conflict with women’s intentions.