When we were filming our 2008 documentary, The Business of Being Born, my director Abby Epstein made several trips to Rio de Janeiro, Brazil. We both became very interested in Rio because it sounded like a place where normal childbirth was being phased out. The statistics we heard were mind boggling -- 93 percent of all babies born to middle and upper-class parents were delivered via cesarean section. Some private hospitals in Rio had an even HIGHER C-section rate than that -- closer to 98 percent! There was actually a joke circulating that the only way to have a natural birth in Rio was if your doctor got stuck in traffic. We shot some fascinating footage, but in the end Brazil was left on the cutting room floor as we decided to focus The Business of Being Born on birth in the U.S.
Five months ago, Abby and I released More Business of Being Born, our four-part follow up series to BOBB. We returned to film in Rio and were able to include a segment on it in MBOBB: Explore Your Options: Doulas, Birth Centers and C-Sections, which The Huffington Post will be streaming free to the public tonight, May 7 at 5 p.m PST/8 p.m. EST. Click here to watch.
There are a myriad of reasons why cesarean section came to be the preferred method of delivery for middle class Brazilians. First off, there is a pervasive and deeply rooted fear of the pain of childbirth handed down from older generations. The cultural fear is so intense that many Brazilian women are terrified of experiencing even the slightest contraction and believe that a vaginal birth will damage their bodies irreparably. Secondly, the physicians and pediatricians do not practice in groups and must be on call for their private patients 24/7. Clearly, that is almost impossible for any human being to achieve unless the births are all scheduled.
Lastly, most of the current generation of obstetricians believe that cesarean delivery is safer than vaginal delivery and not only impart this philosophy to their patients but also refuse clients who are considering a vaginal birth. We were surprised to discover that many of the mothers we interviewed had actually wanted a normal birth but ended up agreeing to a physician-advised cesarean at some point during the pregnancy. Often the cesarean is mandated for vague and benign reasons like an umbilical cord around the baby's neck, which occurs in one-third of all births and normally poses no risk.
Returning to Rio five years later, there is more awareness about the impact of performing so many cesarean surgeries, such as higher rates of maternal morbidity and more premature babies. The natural birth movement is also growing stronger and succeeding in many ways, but the culture does not seem poised to embrace normal birth anytime soon. Essentially, anyone with financial means chooses to deliver their babies via cesarean section without question.
I hope you will join us for the screening tonight: May 7 at 5 p.m. PST/8 p.m. EST followed by a live Q&A with me & Abby at 6:30 p.m. PST/9:30 p.m. EST. Click here to watch it on The Huffington Post.
If you can't catch the whole film tonight, you can see it at www.thebusinessofbeingborn.com.
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