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You can find the current article at its original source at http://www.theguardian.com/commentisfree/2014/apr/10/natural-birth-c-section-choice-brazil-forced-pregnancy
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| Inside a war on natural birth: c-sections as status symbol and 'choice' as a myth | Inside a war on natural birth: c-sections as status symbol and 'choice' as a myth |
| (about 1 hour later) | |
| Adelir Carmen Lemos de Goés just wanted a natural birth. | Adelir Carmen Lemos de Goés just wanted a natural birth. |
| Already a 29-year-old mother of two, she had a trained attendant assisting her; she had a healthy pregnancy. Adelir was perfectly willing to give birth in a hospital; she just prefered to avoid surgery. | Already a 29-year-old mother of two, she had a trained attendant assisting her; she had a healthy pregnancy. Adelir was perfectly willing to give birth in a hospital; she just prefered to avoid surgery. |
| But the hospital, like so many hospitals here in Brazil and elsewhere, thought otherwise: doctors insisted that Adelir's baby was in a breech position, and when Adelir sought to avoid caesarean by trying to sign herself out, in came the authorities. | But the hospital, like so many hospitals here in Brazil and elsewhere, thought otherwise: doctors insisted that Adelir's baby was in a breech position, and when Adelir sought to avoid caesarean by trying to sign herself out, in came the authorities. |
| A Brazilian court granted | A Brazilian court granted |
| a prosecutor's request for the appointment of a special guardian. And just in case | a prosecutor's request for the appointment of a special guardian. And just in case |
| it was unclear whose life gets prioritized when a woman has a c-section against her will, the judge specified that when there | it was unclear whose life gets prioritized when a woman has a c-section against her will, the judge specified that when there |
| is a "conflict of interests of the mother with the child's life ... the interests | is a "conflict of interests of the mother with the child's life ... the interests |
| of the child predominate over hers." | of the child predominate over hers." |
| Ten days ago, Adelir gave birth to a healthy baby girl, | Ten days ago, Adelir gave birth to a healthy baby girl, |
| but she was treated like a criminal. | but she was treated like a criminal. |
| The cops don't always get called to the hospital, but forced or coerced | The cops don't always get called to the hospital, but forced or coerced |
| c-sections are not unusual here in Brazil, where some hospitals deliver almost 100% of babies surgically. And as I've found in my visit across the country with the International Reporting Project, birth plans are as much about | c-sections are not unusual here in Brazil, where some hospitals deliver almost 100% of babies surgically. And as I've found in my visit across the country with the International Reporting Project, birth plans are as much about |
| social class, religion and the role of women in society as they are about so-called choice. | social class, religion and the role of women in society as they are about so-called choice. |
| "In our culture, childbirth is something | "In our culture, childbirth is something |
| that is primitive, ugly, nasty, inconvenient," Dr Simone Diniz, associate | that is primitive, ugly, nasty, inconvenient," Dr Simone Diniz, associate |
| professor in the department of maternal and child health at the University of São Paulo, tells me. "It is something poor women are supposed to endure." | professor in the department of maternal and child health at the University of São Paulo, tells me. "It is something poor women are supposed to endure." |
| By contract, she said, c-sections are seen | By contract, she said, c-sections are seen |
| as "modern and elegant". In Brazil, low-income women largely depend on the | as "modern and elegant". In Brazil, low-income women largely depend on the |
| public health system, which leads to much higher vaginal birth rates, while wealthier | public health system, which leads to much higher vaginal birth rates, while wealthier |
| women use private facilities, making c-sections a kind of status symbol. | women use private facilities, making c-sections a kind of status symbol. |
| When pregnant women come to private | When pregnant women come to private |
| hospitals here and indicate they want to give birth naturally, they're routinely | hospitals here and indicate they want to give birth naturally, they're routinely |
| told that there may not be a bed for them, since all the beds are reserved for | told that there may not be a bed for them, since all the beds are reserved for |
| scheduled deliveries. If a woman does go into labor and doesn't have a | scheduled deliveries. If a woman does go into labor and doesn't have a |
| c-section scheduled, she can find herself boomeranging from hospital to | c-section scheduled, she can find herself boomeranging from hospital to |
| hospital in search of an open bed. Some doctors request bribes if a woman wants | hospital in search of an open bed. Some doctors request bribes if a woman wants |
| to avoid a c-section, since they find unscheduled vaginal births inconvenient. | to avoid a c-section, since they find unscheduled vaginal births inconvenient. |
| As a result, Brazil has one of the highest caesarean birth rates in the world. The World Health Organization recommends a c-section rate of no more than 15%. In private Brazilian hospitals, the | As a result, Brazil has one of the highest caesarean birth rates in the world. The World Health Organization recommends a c-section rate of no more than 15%. In private Brazilian hospitals, the |
| percentage hovers between 80 and 90%. Nationwide, | percentage hovers between 80 and 90%. Nationwide, |
| the c-section rate is upward of 50%. By contrast, about 30% of | the c-section rate is upward of 50%. By contrast, about 30% of |
| American women undergo caesarean births, and that rate is widely considered to be too high. | American women undergo caesarean births, and that rate is widely considered to be too high. |
| For some women, of course, c-sections are more | For some women, of course, c-sections are more |
| convenient, while scheduling a birth offers a sense of control. But others are | convenient, while scheduling a birth offers a sense of control. But others are |
| discouraged either by their doctors or by the reality of vaginal childbirth | discouraged either by their doctors or by the reality of vaginal childbirth |
| here in Brazil, which is often abusive and too often unnecessarily violent. According to Diniz, the | here in Brazil, which is often abusive and too often unnecessarily violent. According to Diniz, the |
| chances of a woman going through vaginal birth and keeping her perineum intact | chances of a woman going through vaginal birth and keeping her perineum intact |
| are less than 5% – doctors routinely and often needlessly perform | are less than 5% – doctors routinely and often needlessly perform |
| episiotomies, where the vaginal opening is cut during childbirth. Women also | episiotomies, where the vaginal opening is cut during childbirth. Women also |
| face verbal abuse from health care providers during childbirth, and the chances | face verbal abuse from health care providers during childbirth, and the chances |
| of a woman being abused increases dramatically if she chooses to go through | of a woman being abused increases dramatically if she chooses to go through |
| labor. | labor. |
| "It's part of Catholic culture that this | "It's part of Catholic culture that this |
| experience of childbirth should come with humiliation," Diniz says. | experience of childbirth should come with humiliation," Diniz says. |
| Abortion is also illegal in Brazil, yet | Abortion is also illegal in Brazil, yet |
| more than 1m illicit procedures are performed every year. As recently as | more than 1m illicit procedures are performed every year. As recently as |
| 2009, illegal abortion was the leading cause of maternal death here in Sao Paolo, | 2009, illegal abortion was the leading cause of maternal death here in Sao Paolo, |
| the largest city in Latin America. And last week, a Brazilian research | the largest city in Latin America. And last week, a Brazilian research |
| organization released the results of a survey | organization released the results of a survey |
| indicating that large numbers of Brazilians think the way a woman dresses or | indicating that large numbers of Brazilians think the way a woman dresses or |
| acts may justify rape. | acts may justify rape. |
| Forced and coerced c-sections, abusive birth | Forced and coerced c-sections, abusive birth |
| practices, restrictive abortion laws and adherence to the she-was-asking-for-it rape myth – these malpractices all exist on the same continuum of belief: that women's bodies are | practices, restrictive abortion laws and adherence to the she-was-asking-for-it rape myth – these malpractices all exist on the same continuum of belief: that women's bodies are |
| public property. But when it comes to reproduction, those values also often prove illusive – women in America, too, have been forced into c-sections, and many of our reproductive choices remain overly politicized. | public property. But when it comes to reproduction, those values also often prove illusive – women in America, too, have been forced into c-sections, and many of our reproductive choices remain overly politicized. |
| On Friday, advocates for | On Friday, advocates for |
| reproductive freedom will rally at Brazilian embassies around the world. On | reproductive freedom will rally at Brazilian embassies around the world. On |
| Twitter, activists are organizing under the hashtag #SomosTodasAdelir – "We | |
| Are All Adelir". There's a conceit back home that America is the land of freedom | Are All Adelir". There's a conceit back home that America is the land of freedom |
| and choice. But when it comes to reproduction, those values too often prove illusive. | and choice. But when it comes to reproduction, those values too often prove illusive. |
| From Sao Paolo to San Antonio to Seattle, we are all closer to being Adelir | From Sao Paolo to San Antonio to Seattle, we are all closer to being Adelir |
| than we think. | than we think. |