In Brazil, 85% of women who give birth in a private clinic give birth by caesarean section. In the Netherlands, less than 5% of women use epidurals and almost one in three give birth at home. In China, women traditionally spend a month recovering after the birth of their baby. Around the world practices and customs surrounding childbirth.
Brazil: cesarean = modernity
In Brazil, childbirth is highly medicalized and caesareans for “personal convenience” are the norm. In the private sector, about 85% of births are by caesarean section (a quarter of births take place in private clinics). In public hospitals, the delivery rate by caesarean section has been reduced to 45% thanks to a government policy penalizing hospitals with a high caesarean section quota. Indeed according to the WHO, an optimal rate of caesarean deliveries should be between 5 to 15% of the tota l (in France, 83% of births occur vaginally).
The reason given for this high rate of caesarean section is primarily pragmatic: a scheduled cesarean delivery is faster and more cost effective because more expensive . Then, the medical culture of childbirth in Brazil makes the conditions of a natural childbirth difficult. Maria do Carmo Leal, researcher at the National School of Public Health explains :
“Here, when a woman is about to give birth, even in a natural way, the first thing most hospitals do is to nail her to bed with an IV in her arm, so she does not can not walk, take a shower, or hug her husband. The use of drugs to accelerate contractions is very common, as is episiotomy. What you get is a lot of pain and a horrible childbirth. That makes Cesarean a dream for many women. ”
Natural childbirth is thus seen in Brazilian culture as wild and primitive, while cesarean delivery is civilized and modern . The latter is so widespread that it is difficult to obtain a bed in a maternity hospital without having previously opted for a caesarean section. Pedro de Britto Pereira, obstetrician and professor at the Federal University of Rio de Janeiro confirms to the BBC : “the best way to guarantee a bed in a good hospital is to reserve for a cesarean section”.
In protest, a couple chose to give birth naturally, at home with the help of a midwife, and to mediate the photos taken during this time for the purpose of raising awareness.
Netherlands: natural childbirth par excellence
In the Netherlands, it is the opposite extreme. Pregnancy and birth are considered normal life stages and not a medical condition. In this respect, pregnant women are not treated as patients, medical procedures are not encouraged and home delivery is legion.
Without high-risk pregnancies or complications, it is the midwives who monitor the pregnancy and give birth to the children. 30% of women who give birth to their first child do so at home and this figure rises to 60% for the second child (in France home birth accounts for 1 to 2% of total births). In case of birth in the hospital, the mother returns home with her newborn usually only a few hours after delivery. This is made possible by a very low medicalization of childbirth. Thus, only 5% of parturients use the epidural (against 77% in France during a vaginal delivery), the Dutch favoring a natural birth. Back home, the parents are not left to their own home care is provided and supported by social security: for a week, a maternal assistant, called Kraamzorg, help for 2 to 6 hours per day care of the infant, but also the household, the kitchen, etc.
In most other European countries, home birth is often viewed with a bad eye and considered dangerous for the mother and her child. Yet the infant mortality rate in the Netherlands is at the same level as the other European countries: 3.8 per 1000 births , the same rate as in the United Kingdom (the European average is 3.7 / 1000). Of studies conducted in the United Kingdom, the United States, the Netherlands, Switzerland and New Zealand have concluded that home birth, when not against-indicated and under the supervision of a midwife, did not increase the risk of infant mortality.
China: millenary traditions still relevant
While childbirth in China is largely medicalized with nearly half of births by caesarean section , it is after the birth of the baby that age-old traditions come into play: Zuo Yue Zi or literally ” sitting one month “. Young mothers are indeed required to rest for a I s after the birth of their child to recover.
Vulnerable after giving birth, they must not take cold and this results in a ban on washing , especially the hair (only a basic toilet with a towel soaked in water, alcohol and salt is allowed), eat raw or “cold” food, turn on the air conditioning and open the windows. All activities that could exhaust the young mother are prohibited, including reading or watching TV. If delivery took place by caesarean section, she will be able to leave her bed only to go to the toilet. Caring for the baby and the mother during this month of confinement is the responsibility of the paternal or maternal grandmother.
In the popular imagination, if these rules are not respected the rule, the woman will be more easily prone to migraines and diseases like arthritis in her old days.
And you, how did you live or do you plan your delivery?