Brazil’s Cesarean Surge Linked to Social, Psychological and Structural Factors

A UN‑UNICEF study released on 13 July 2026 examined why the majority of Brazilian births are by cesarean section. While the World Health Organization recommends a maximum of 15 % of deliveries be surgical, Brazil records over 60 % overall and up to 90 % in the private health system, placing the country among the three with the highest rates worldwide.

The research combined a literature review with interviews of 94 pregnant or postpartum women and 37 health‑care professionals in São Paulo and Belém. Findings show that fear of pain and the desire for a quicker recovery drive many women toward surgery. Social influences—especially stories from mothers, grand‑mothers and other relatives—shape perceptions of normal versus cesarean birth, while structural issues such as limited access to analgesia, inadequate support networks, and private‑sector incentives (including the convenience of scheduled surgeries and the option of tubal ligation) further raise the cesarean proportion. In São Paulo, 56.19 % of all births and 71.05 % of private‑hospital births were cesarean; in Belém the figures were 69.28 % overall and 80.41 % in private facilities.

The study also highlighted obstetric violence, with many women reporting unnecessary interventions and disrespectful treatment. Stephanie Amaral, UNICEF Brazil’s health and nutrition specialist, noted, “Reports of highly disrespectful births, unnecessary episiotomies and other interventions are widespread.” Women using the public SUS system tended to value natural birth more, citing post‑operative difficulties and a lack of familial support, whereas private‑sector patients often did not mention support deficits.

UNICEF stresses that the challenge is not to persuade women but to ensure they have reliable information, qualified care, access to pain relief, and supportive networks so they can choose safe, respectful delivery options.