Richer women have caesarean sections

Women from families with higher incomes and higher levels of education have caesarean sections more often than those with lower incomes or of a lower educational level. In Brazil, 55% of women earning more than $1000 (£700; 1145) a month have a caesarean section, well above the 15% maximum recommended by the World Health Organization. A study by Béhague and colleagues (p 942) shows that the fear of substandard care is the main reason behind many women's preference, not lack of knowledge or fear of the physiological consequences of vaginal delivery, as was previously thought. The authors call for better educational interventions to educate doctors and patients about the risk factors associated with caesarean sections.

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Relevant Article

Consumer demand for caesarean sections in Brazil: informed decision making, patient choice, or social inequality? A population based birth cohort study linking ethnographic and epidemiological methods

Dominique P Béhague, Cesar G Victora, and Fernando C Barros
BMJ 2002 324: 942. [Abstract] [Full Text] [PDF]