State and private hospitals perform more cesareans than internationally recommended
No matter the warnings, Portugal’s state and private hospitals are still performing more cesarean births than recommended.
One in three babies born in public hospitals enters the world this way, instead of through the birth canal – which provides ‘healthy bacteria’ for the baby’s immune system, not to mention avoiding the risks of cesarean births which are, essentially, surgical procedures.
Entreaties for Portugal to fix its mechanical approach to childbirth appear to have fallen by the wayside. Today’s report in best-selling tabloid Correio da Manhã barely refers to them, carrying only a small side story on the ‘risks of surgery’, particularly for the mother- while trotting out percentages on the number of these births performed around the country as if they were somehow ‘remarkable’ (in a good way).
Figures for the first three months of this year show that of the 15,731 births in state hospitals, 5,235 (33.3%) were cesareans. “This is the highest number ever”, says the paper.
“In 2024, cesareans represented 32.6% of the 64,503 births in the state health system (SNS), while the year before they were 32.2%, and in 2021 they represented 31.6%”.
CM then trots out the percentage of cesarean births per area: Bragança having the highest (half the births registered in the northeast health unit were performed by cesarean section), followed by Póvoa de Varzim (41.9%), Portalegre (41.8%), Caldas da Rainha (41.7%), Famalicão (41.6%)… and so it goes on, until the health unit with the lowest score, Castelo Branco, where 19.5% of births were cesareans so far this year – which is still higher than the World Health Authority recommendation of 10-15%…
Worse, is that CM’s data “does not include private hospitals where the level of cesarean births is much higher than in the SNS”. Indeed, it is often described as ‘almost double’.
Portugal’s level of cesarean births is not unique. An online search will confirm that C-sections (as these births are often termed) “have been steadily increasing globally, with some regions experiencing rates far exceeding the recommended range.
In some cases, C-sections are performed without a clear medical indication, potentially due to factors like convenience for the healthcare provider, fear of litigation, or perceived time constraints. Studies reported in the Lancet referred to procedures being done “when it is not really necessary or indicated”.
Efforts are underway to address the overuse of C-sections and promote safer, more appropriate birth practices. This includes providing evidence-based guidelines for labour management, emphasising the importance of shared decision-making between healthcare providers and patients, and addressing factors that contribute to the overuse of C-sections. In 2017, for example, the SNS actually threatened to sue hospitals that performed too many cesareans.
In the meantime, the decision by many expectant mothers to ‘deliver their babies at home, with a midwife/ doula’ can be put into perspective. It is not the ‘mad whim’ that authorities have liked to lable it in the past, but a considered approach in an environment that may not be thinking primarily of ‘what is best for mother and baby’.
Source: Correio da Manhã
