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Why so many c-sections in Venezuela?

Giving birth naturally is becoming more difficult as doctors and women opt for cesarean sections.

baby Venezuela hospital
Venezuelan President Hugo Chavez visits a newborn baby as he attends the re-inauguration of a university hospital in Maracaibo, March 24, 2008. (Ho-Miraflores Palace/Handout/Reuters)

CARACAS, Venezuela — When giving birth to her daughter, Carolina Vazquez remembers tiptoeing down the corridors of her clinic as she tried to avoid doctors.

Vazquez was determined to give birth naturally and feared she would be coerced into a cesarean.

“My obstetrician was telling me to hurry up so they wouldn’t see me,” she recalled. “She was arranging for this or that doctor not to come in that day — I always call my daughter’s arrival a clandestine birth.”

Giving birth naturally (or vaginally) in Venezuela is becoming increasingly difficult as doctors and women opt for the perceived safety of a c-section.

Cesarean rates in some private clinics are as high as 90 percent, while even in public hospitals almost three in 10 women go under the knife, according to several doctors.

It’s a worldwide trend that has alarmed some doctors. A recent World Health Organization report said c-sections have reached “epidemic proportions” in many countries.

For Vazquez, the experience inspired her to set up Aquamater, one of just two clinics in Caracas dedicated to offering women the option of a natural labor. The clinic provides all the equipment and expertise for a woman to give birth exactly as she wants, including a birthing bath and facilitators to assist during labor.

But there is also an operating room available in case an emergency cesarean is required, she stressed.

Vazquez is determined to fight the prevailing culture for cesareans in Venezuela. Yet since she set up the clinic more than a decade ago, the cesarean rate in Venezuela has climbed.

Dr. Saul Kizer, an obstetrician at La Arboleda clinic in central Caracas, said the rate had increased by 22 percent between 2000 and 2009 in two private clinics he surveyed (the clinics requested anonymity).

Even at Aquamater, the cesarean rate rose to 45 percent since the clinic began offering a service that provides cheap rates to teenage mothers, many of whom go because of the lower cost not because they want to give birth naturally.

Vazquez, a psychologist by training, believes the cesarean rate in Venezuela may be party driven by profit margins. After all, surgery is quicker than labor (an hour against 10 to 12 hours), pays up to 50 percent more and doctors can schedule deliveries into regular working hours.

That has prompted a kind of strong-arming by doctors who coerce worried mothers into surgery, said Vazquez. “Ignorance makes women easy prisoners of medical manipulation,” she said. “There’s a deification of medicine here — doctors behave and are treated by patients as demi-gods who know everything.”

But Kizer says much of the pressure often comes from women and their families. “In the last two decades a new term has emerged known as the elective cesarean,” he said. “The woman has no indication of medical, obstetric or fetal problem but she still wants to have a cesarean.”