Luxury birthing clinics spur cesarean ‘epidemic’ in Brazil

RIO DE JANEIRO — Thais Faria sank into a leather love seat, relaxing under the ministrations first of a masseuse, then a manicurist and finally a hairdresser-cum-makeup artist. Not 24 hours after her daughter was born via cesarean, Faria was being pampered at an upscale Rio de Janeiro maternity clinic.

Cesarean births aren’t typically associated with luxury. But the procedures have become de rigueur among Brazil’s wealthy, with new mothers at some high-end clinics enjoying beauty treatments after the operation in a culture that has come to regard births as glamorous social events — equal parts spa, cocktail party and family get-together. In private clinics nationwide, C-sections account for more than eight of every 10 births.

Authorities want to turn the tide on what Health Ministry officials have called an “epidemic” of cesareans births in the country, with Brazil now the world’s No. 2 recipient of C-sections, second only to China in raw numbers. They have designed new rules aimed at discouraging the procedure when it’s medically unnecessary, saying C-sections dramatically raise the risk of respiratory problems for the infant and death for the mother.

C-sections aren’t more costly than natural births, but many Brazilian doctors prefer to perform surgeries, which end up being more lucrative and more convenient over the long run because they can be scheduled during regular work hours.

The vast majority of Brazil’s mothers-to-be also prefer C-sections, which have become something of a status symbol. Even in the country’s poor public hospitals, where any Brazilian can seek free health care, C-sections represent around 40 percent of deliveries — more than the United States’ 33 percent cesarean rate, which public health experts consider high. In France, C-sections account for around 20 percent of births; in Sweden, 17 percent.

“The very special first meeting of mother and child has been transformed into a party. And any party has to have a specific time and place, so hence the cesareans,” said Dr. Marcos Dias, a Rio obstetrician who advocates natural childbirth.

At the Perinatal private clinic, where Faria gave birth to her first child, women reserve their spot upon learning of their pregnancies, booking their cesareans months in advance. Fridays are the most popular, because they allow for weekend visits by friends and family.

Ostensibly aimed at bolstering new mom’s self-esteem, Shiatsu massages, mani-pedis and makeovers to prepare fatigued new mothers for their close-ups are included in the standard package at the Perinatal. With its uniformed bellhops pushing luggage-laden roller carts and a cafe serving flutes of Champagne, the clinic more resembles a boutique hotel than a hospital.

In clinics like Perinatal, most new mothers have medical insurance that cover the $4,200 price tag of the C-sections, plus a three-day stay in a private room. But that cost can rise considerably. Women with deep pockets can also choose from a selection of pricey extras including personalized room decorations that average about $400, camera and video crews to document the big event and in-room catered buffets costing about $200-$400. For an extra $270, they can rent the Cine Perinatal, a private room where up to 14 guests can follow the birth on a giant flat screen TV as they nibble on hors d’oeuvres. The clinic’s seven deluxe suites aren’t covered by health insurance plans and run an extra $500 for the standard three-night stay.

New mother Faria chose a deluxe suite and also splurged on personalized decorations. Pink bears that held balloons emblazoned with newborn Rafaella’s name decorated the two-room suite. Bears concocted of pink sugar sat atop a multi-tiered cake, the centerpiece of a spread that included bottles of bubbly, their labels papered over with pink stickers reading “Rafaella.”

“The birth of your child is such a special event, it’s only natural that you want it to be perfect,” said Faria, a 29-year-old dentist whose long, perfectly blown out locks and natural-look makeup belied the fact she’d undergone major surgery a day before. “This is all part of the package.”

Analusa Feitosa, Perinatal’s head of nursing, said such perks set the clinic apart and the extras help new mothers recover after giving birth.

“Their self-esteem takes a bruising, they’re chubby, swollen and in their heads they see themselves as having been transformed” by the pregnancy, said Feitosa. “Show me a woman who wouldn’t like to wake up with someone there to make her up, to take care of her.”

Lumena Furtado, head of the Health Ministry’s secretariat of health attention, said the new regulations aimed at discouraging unnecessary C-sections are designed to temper Brazilians’ view of the procedure with a stiff dose of reality. Mothers opting for cesareans must sign a document stating they’re aware of health risks for themselves and their infants. Insurance companies must provide cesarean rates for obstetricians and clinics upon request.

“Our cesarean rate here in Brazil is unacceptable,” said Furtado. “We need to see a cultural shift.”

Still, officials acknowledge it could be difficult to change attitudes now that the cesarean birthing experience has become an important event on wealthy people’s social calendars.

Adriana Romualdo, whose company Julubeca decorates deluxe suites and provides other high-end services for new parents, says her clients gush about the experience.

“They tell me, ‘If the birth was like that, imagine the baptism, the sweet sixteen party and the wedding,’” said Romualdo. “It’ll have to take place in a cathedral.”


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