Where is this leading? What it looks like when systemic birth interventions go unchecked

Sometimes when I speak with women and parents about birth interventions and systemic trauma, they wonder aloud “where does this end?”
The answer is this: left unchecked, it doesn’t.
In Brazil 82% of private hospital births are Caesareans. The total rate across the country is 55.8%. The episiotomy rate for vaginal birth is 94.2%.
The article “Why Most Brazilian Women Get C-Sections” in The Atlantic explains in detail, but in short:
-It’s a way to “optimise” birth speed and money-making for doctors and institutions;
-Obstetrician and practitioner fear of litigation;
-Patriarchal/power-over hospital culture;
-Coercion, bullying and highly medicalised vaginal delivery making more pregnant women/birthing people seek early c-sec to avoid the psychological and pelvic floor harm. 
In this way, c-sec (a major abdominal surgery with serious risks) becomes packaged as an autonomous decision for the majority of patients, rather than the minority. Physiological birth is forgotten within generations, trust in ourselves diminishes, culture cements the role of the surgeon as essential for the many not the few.
Sound familiar?
In Australia the current rate of c-sec is 37% and episiotomy is 25%, leaving only 38% uncut. It has gotten worse at every annual time check for decades, with no improvement in infant deaths or maternal mortality.
When an independent midwife provides pregnancy, birth and postpartum care outside the OB-led hospital systems, the c-sec rates drops to 4.7% and episiotomy to 1.26%, leaving 94.04% uncut.
Across the world, birth systems are the problem, not those birthing in them. It’s time to dismantle and rebuild them based on what we know works best for mothers, birth parents and babies: continuity of midwifery care, with OB support only if (not when) needed. We can’t wait any longer for things to get better, because unless we make change, they simply won’t.


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