Brazil works to encourage normal births

Brazil's Health Ministry and the National Regulatory Agency for Private Health Insurance and Plans (ANS) published on Wednesday (Dec 7) a resolution which sets forth new norms aimed at encouraging normal births and reduce the number of unnecessary cesareans. Health insurers have been given 180 to adapt to the changes.

The new rules provide for more access to information by allowing customers to ask for the percentage of cesarean sections and normal births conducted at a given institution or by an obstetrician. The data must be available within 15 days of the customer's request, with fines applicable.

Another norm makes it mandatory for health insurers to provide customers with the so-called Pregnant Woman's Card, in which all information concerning the pregnant woman's prenatal care is stored. Health professionals will therefore be able to learn about the patient's pregnancy and thus offer the necessary type of care.

It will also be one of the insurers' duties to advise obstetricians as to how they should use partograms, a document which registers whatever takes place during labor. According to the new regulations, partograms will be required for the payment of the procedure.

Data from the ministry reveal that the percentage of cesarean sections in Brazil amounts to 84% at private health institutions. According to the government department, when there is no specific medical recommendation for this kind of birth, breathing problems may become 120% more likely to afflict the baby, while mothers are three times as likely to die. Overall, nearly 25% of neonatal deaths and 16% of child deaths in the country are related to prematurity.

“We must not tolerate this cesarean epidemic we're witnessing today. [It's] a serious public health problem. In 2013, 440 thousand cesareans were reported. [It's] a problem that has grown more serious every year,” Health Minister Arthur Chioro cautions.  “We can't keep treating as normal something that isn't normal, namely cesarean births.”

ANS Presiding Director André Longo, in turn, said he believes measures can function in cooperation, “so that we overcome the veritable cesarean epidemic at private hospitals that has exerted a negative influence on Brazil's figures as a whole.”

The resolution was drafted by members of society during a public consultation held in October and November last year.

Translated by Fabrício Ferreira