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Urgent action needed to improve maternal care in Latin America
April 16, 2002Unnecessary caesarean section is known to increase health risks for both mother and infant, while routine episiotomy has no benefit. Two studies in this week’s BMJ illustrate the gap between evidence and practice in maternal care.
The first study shows that many poor women in Brazil actively seek a caesarean section because of fear of substandard labour care, including lack of pain control.
Rich women were more likely to have caesarean sections, and a vaginal birth was considered a risky and negative experience. Many lower to middle class women sought caesarean sections to avoid what they considered poorer quality labour care.
The second study found that nine in every 10 women who gave birth spontaneously in hospitals in Latin America between 1995 and 1998 had an episiotomy, despite evidence that the procedure is not justified.
This situation is inadmissible in the light of the current evidence, and the challenge now is to change the use of episiotomy in Latin American hospitals, say the authors.
Making substantial progress towards improving the quality of maternal health care is urgent, writes Ana Langer, in an accompanying editorial. While we continue to discuss unnecessary surgical interventions, millions of women that require these procedures do not have access to them and risk their own and their children’s lives.
British Medical Journal (BMJ)
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