In Brazil, Fighting for a Natural Birth

I knew all the benefits of a natural delivery and the risks of a C-section. But people told me I was crazy.

By Flávia Roberta Wiezel (as told to Patricia Campos Mello)

More than 80 percent of women in Brazil’s private hospitals — and half of those in public hospitals — give birth through Caesarean section. Brazil’s C-section rates are notoriously among the highest in the world; the World Health Organization recommends that the “ideal rate” for C-sections in a population to be between 10–15%.

Recently, the Brazilian government has taken some steps to promote natural births, like an initiative that declares, “Childbirth is normal!” But individual women around the country — like 30-year old Flávia Roberta Wiezel, a dentist who lives several hours outside São Paulo — still face a stigma when they approach their doctors for a natural birth. She shares her story here.

I was so mad. I couldn’t believe what my doctor was telling me.

I was 36 weeks pregnant, sitting in my doctor’s office with my husband Marcelo. She said she wouldn’t wait more than 40 weeks for my daughter to be born, because it was too risky for the baby, and she wouldn’t allow me to be in labor for more than 12 hours. Bottom line, she couldn’t guarantee that I would have a natural birth. Oh, and there was no possibility of my doula accompanying me through labor. She would not allow “this kind of person” in her operating room. And no, my husband was not allowed to be with me during the whole time, only during delivery.

But the worst was yet to come. When I told her I did not want the episiotomy (the incision that sometimes makes it easier for the baby to pass through during delivery), she looked at me and asked, “Do you know why you need an episiotomy? For you not to become “loose” like your grandmother and your great-grandmother. Or do you want to have your baby and next thing you know, your husband dumps you for your neighbor?”

I was speechless. Until that moment, the doctor was being agreeable and saying of course we are going to do everything we can for you to have a natural birth.

We left the office and I was crying. I told my husband that we would find a new doctor. He agreed. But it is not easy to find OB-GYNs in Brazil who agree to perform natural births.

There’s a financial incentive to perform C-sections — instead of “wasting” twenty hours monitoring a natural birth, a doctor can do as many as four C-sections procedures during the same time, and be paid accordingly.

I found a great doctor in Americana, which is a 15-minute drive from my home. Of course I had to pay out of pocket, as it was not easy to find a new doctor at the last minute.

He agreed to conduct a natural birth and said, “Your baby doesn’t have expiration date; we are going to wait until your daughter is ready to be born. There is no rush. If you approach 42 weeks, then we will use labor induction. But there’s no way we are going to schedule a C-section when you are 40 weeks pregnant. And we are only going to perform the episiotomy if it is really necessary.”

I was relieved.

After I entered the 39th week, I was monitoring the fetus every two days, so I knew everything was OK with the baby. And I had read a lot, I knew all the benefits of a natural delivery.

But many people criticized me and I felt scared. I felt as if I held sole responsibility if something went wrong.

People told me I was crazy. “You are 40 weeks pregnant? You have to have a C-section, your baby is going to die, that’s what happened to a friend of mine,” said one woman. “Why do you want to feel pain? Do you want to have your baby like the índios (indigenous people in Brazil)?” asked another.

I went into labor in my 41st week of pregnancy. It was 3am on December 23rd, 2014. Isabela was born 26 hours later.

During labor, I stayed home with my doula and an obstetric nurse, who was monitoring me the whole time. She was the one who would tell me when it would be time to go to the hospital.

My husband was with me the whole time. I was in a lot of pain. It got a little better when I was kneeling in the couch or in the shower, on a ball.

When it was 4am the following day, I told my husband, “I can’t take the pain anymore, I need anesthetics.”

And he said, “Remember what you asked me? You told me not to let you get anesthetics, even if it’s hurting a lot… We are almost there, hang on a little more.” I did, and Isabela was born just as I had imagined. I arrived at the hospital at 5:08am. She was born 12 minutes later.

For me, it was a victory.

It was very easy to breastfeed. The milk came in very quickly because I had been in labor for so many hours. When you have a C-section, sometimes it takes a while for the milk to come in. And Isabela easily learned to nurse.

After delivery, I had no cuts, no stitches, no lacerations. I was ready to take care of my daughter.

Isabela, who turned one last December, is a very self-assured baby. She sleeps through the night. Her health is excellent: she’s never had even a cold. The only medicine she’s ever had to take was Tylenol because of the shots.

I’m positive that the natural birth has helped her to have such good health. Natural birth is simply the type of delivery that caters to the needs of the baby and the mother, nothing more than that. When my doctor refused to do that, I felt disrespected.

I would like to get pregnant again by the end of the year. This time, I want to give birth at home. My husband is still reluctant. But I’m going to convince him. I’ve seen that it is safe, and a nurse is going to accompany me all the way through labor and delivery.

I feel lucky. When Isabela was born, there were another seven other babies in the maternity ward. They were all delivered through C-sections. Maybe their mothers also wanted natural births, but couldn’t convince their doctors.

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