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World Champion in C-section, Brazil Celebrates that Normal Birth Is Up 1%

A child being born through a C-section A child being born through a C-section

 

Since 2009, Brazil became the first country in the world where more babies are born via C-section instead of through normal birth. Numbers from 2013 showed that 55,6% of births in the country were cesareans.

The international average is 30%, although the World Health Organization considers 10% to 15% to be the ideal rate of C-section births.

New data now show that for the first time since 2010, the number of cesarean sections in the public and private healthcare network has not grown in Brazil.

Data released earlier this month by the Brazilian Ministry of Health show that this procedure, which has been in an upward curve, dropped 1.5 percentage point in 2015.

Of the 3 million deliveries made in Brazil in the period, 55.5% were by C-section and 44.5% were normal births.

Data also show that, considering only deliveries performed in Brazil’s Unified Health Care System (SUS), the percentage of normal births remains higher-59.8% against 40.2% of C-section.

According to the ministry, last year preliminary data indicate a stabilization in the number of C-section, at around 55.5%.

The government announced new guidelines for care in normal birth, which will be used for consultation by health providers and pregnant women.

“From now on, every woman will have the right to define her birth plan, which will have information on the place where she will give birth, guidelines, and benefits of the normal birth for example,” reported the ministry.

According to the health ministry report, these guidelines are designed to ensure pregnant women are treated with respect by health providers and empower them to make more informed childbirth choices.

“This means childbirth will be dealt with less like a set of methods and more like a vital mother-and-baby moment,” it went on.

The ministry credited the stabilization in the number of C-sections in Brazil to such policies as the Rede Cegonha (Stork Network) mother-and-baby care program; investment in 15 birth centers; qualification of high-risk maternity hospitals; a larger presence of midwifery nurses at the delivery scene, and a closer role of the National Regulatory Agency for Private Health Insurance and Plans (ANS) at delivery method decision-making.

In 2016, the health ministry published a Clinical Protocol with C-Section Care Guidelines outlining the standards that should be adhered to by health services. It is designed to guide health workers and help them avoid unnecessary C-sections, since inappropriately recommended cesareans carry higher respiratory risks for newborns and higher risks of maternal and infant death.

500 Attacks an Hour

A total of 503 Brazilian women suffered some sort of physical aggression every hour in 2016, a survey conducted by DataFolha and commissioned by the Forum on Public Safety found.

The study, released March 8, included face-to-face interviews across 130 Brazilian municipalities. A total 4.4 million women – 9% of them above the age of 16 – say they were punched, kicked, pushed, or suffered some other form of violence.

Moral and verbal attacks, like swearing and humiliation, were reported by 22% of the female population. Last year, 29% of women experienced some sort of violence, physical or moral. Among black women, the rate reaches 32.5%, and 45% among young women (aged 16-24).

Four percent of women (1.9 million) fell victims to threats with guns or knives. Beating and strangling victimized 3%, or 1.4 million women, whereas 257 thousand, 1%, were shot.

Two of every three Brazilians – both men and women included – witnessed some sort of violence against women in 2016, ranging from direct physical attacks to harassment, threats, and humiliation – 73% among black women and 60% among white.

Most aggressors, according to women’s reports, are their own acquaintances (61%). Spouses, partners, and boyfriends account for 19% of the cases. Former partners total 16%.

The victims’ own house was the most often mentioned place where attacks took place (43%). Of women aged 35-44, 38% of the aggressions were perpetrated by spouses or boyfriends.

When asked how they reacted after the attack, 52% of the women said they did not do anything. Thirteen percent sought support from family members; 12% from friends, and 11% went to a special police station for women. As for young ones, aged 16-24, the rate of those who showed no reaction amounts to 59%.

A total of 40% of women were attacked last year. For women aged 16 to 24 years old, the index totals 70%, with 68% of whom having heard disrespectful remarks out on the streets. The percentage reaches 52 among women aged 25 to 34 years old. In this group, 47% were attacked on the streets, 19% in the work place, and 15% on public transport.

Senate Approves Same-sex Union

The Senate’s Constitution and Justice Commission (CJJ) approved a bill aimed at recognizing same-sex unions and allowing them to turn into marriage.

The vote was definitive and the bill will be submitted to the lower house for deliberation in case no appeal is filed on the move, in which case the matter would have be voted on by the full house.

Under Brazilian law, a family is “the stable union between a man and a woman in the form of a public, ongoing and long-lasting union, constituted with the purpose of building a family.”

The bill, known as PLS 612/2011 stipulates a change to “two people,” preserving the remainder of the text.

In 2011, Brazil’s Supreme Court unanimously voted to recognize same-sex civil union as a family. In practice, the decision means that the rules governing civil union between a man and a woman are to apply for gay couples as well.

In 2013, the National Justice Council approved a resolution which mandates that all notary’s offices across the country should acknowledge these unions and grant them marriage status after different interpretations on the matter arose.

Senator Roberto Requião, rapporteur in the case, mentioned the Supreme Court’s decision in his report, and said that the Legislative branch is responsible for making the law suit the understanding of the top court, in order to eliminate obstacles and provide legal security to same-sex couples. The bill was presented by Senator Marta Suplicy.

“It is the duty of the Legislative Power to fulfill its role and bring the clauses in the Civil Code in accordance with the distinguished understanding of the Supreme Court, as proposed in the bill brought forward by Senator Marta Suplicy, and contribute to the increase of legal security and ultimately the dissemination of social peace,” Requião’s report reads.

ABr

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It seems the future never arrives in Brazil What Lies Ahead in Brazil? Brazil Has No Exemplary Past or Present. But What Lies Ahead for the Country? Europeans, US, developed country, developing country. Bolsonaro, future B. Michael Rubin For years, experts have debated what separates a developing country from a developed one. The GDP (Gross Domestic Product) of a country is one simple way to measure its economic development. Another way to measure a country's progress is the extent of public education, e.g. how many citizens complete high school. A country's health may be measured by the effectiveness of its healthcare system, for example, life expectancy and infant mortality. With these measurement tools, it's easier to gauge the difference between a country like Brazil and one like the U.S. What's not easy to gauge is how these two countries developed so differently when they were both "discovered" at the same time. In 1492 and 1500 respectively, the U.S. and Brazil fell under the spell of white Europeans for the first time. While the British and Portuguese had the same modus operandi, namely, to exploit their discoveries for whatever they had to offer, not to mention extinguishing the native Americans already living there if they got in the way, the end result turned out significantly different in the U.S. than in Brazil. There are several theories on how/why the U.S. developed at a faster pace than Brazil. The theories originate via contrasting perspectives – from psychology to economics to geography. One of the most popular theories suggests the divergence between the two countries is linked to politics, i.e. the U.S. established a democratic government in 1776, while Brazil's democracy it could be said began only in earnest in the 1980s. This theory states that the Portuguese monarchy, as well as the 19th and 20th century oligarchies that followed it, had no motivation to invest in industrial development or education of the masses. Rather, Brazil was prized for its cheap and plentiful labor to mine the rich soil of its vast land. There is another theory based on collective psychology that says the first U.S. colonizers from England were workaholic Puritans, who avoided dancing and music in place of work and religious devotion. They labored six days a week then spent all of Sunday in church. Meanwhile, the white settlers in Brazil were unambitious criminals who had been freed from prison in Portugal in exchange for settling in Brazil. The Marxist interpretation of why Brazil lags behind the U.S. was best summarized by Eduardo Galeano, the Uruguayan writer, in 1970. Galeano said five hundred years ago the U.S. had the good fortune of bad fortune. What he meant was the natural riches of Brazil – gold, silver, and diamonds – made it ripe for exploitation by western Europe. Whereas in the U.S., lacking such riches, the thirteen colonies were economically insignificant to the British. Instead, U.S. industrialization had official encouragement from England, resulting in early diversification of its exports and rapid development of manufacturing. II Leaving this debate to the historians, let us turn our focus to the future. According to global projections by several economic strategists, what lies ahead for Brazil, the U.S., and the rest of the world is startling. Projections forecast that based on GDP growth, in 2050 the world's largest economy will be China, not the U.S. In third place will be India, and in fourth – Brazil. With the ascendency of three-fourths of the BRIC countries over the next decades, it will be important to reevaluate the terms developed and developing. In thirty years, it may no longer be necessary to accept the label characterized by Nelson Rodrigues's famous phrase "complexo de vira-lata," for Brazil's national inferiority complex. For Brazilians, this future scenario presents glistening hope. A country with stronger economic power would mean the government has greater wealth to expend on infrastructure, crime control, education, healthcare, etc. What many Brazilians are not cognizant of are the pitfalls of economic prosperity. While Brazilians today may be envious of their wealthier northern neighbors, there are some aspects of a developed country's profile that are not worth envying. For example, the U.S. today far exceeds Brazil in the number of suicides, prescription drug overdoses, and mass shootings. GDP growth and economic projections depend on multiple variables, chief among them the global economic situation and worldwide political stability. A war in the Middle East, for example, can affect oil production and have global ramifications. Political stability within a country is also essential to its economic health. Elected presidents play a crucial role in a country's progress, especially as presidents may differ radically in their worldview. The political paths of the U.S. and Brazil are parallel today. In both countries, we've seen a left-wing regime (Obama/PT) followed by a far-right populist one (Trump/Bolsonaro), surprising many outside observers, and in the U.S. contradicting every political pollster, all of whom predicted a Trump loss to Hillary Clinton in 2016. In Brazil, although Bolsonaro was elected by a clear majority, his triumph has created a powerful emotional polarization in the country similar to what is happening in the U.S. Families, friends, and colleagues have split in a love/hate relationship toward the current presidents in the U.S. and Brazil, leaving broken friendships and family ties. Both presidents face enormous challenges to keep their campaign promises. In Brazil, a sluggish economy just recovering from a recession shows no signs of robust GDP growth for at least the next two years. High unemployment continues to devastate the consumer confidence index in Brazil, and Bolsonaro is suffering under his campaign boasts that his Economy Minister, Paulo Guedes, has all the answers to fix Brazil's slump. Additionally, there is no end to the destruction caused by corruption in Brazil. Some experts believe corruption to be the main reason why Brazil has one of the world's largest wealth inequality gaps. Political corruption robs government coffers of desperately needed funds for education and infrastructure, in addition to creating an atmosphere that encourages everyday citizens to underreport income and engage in the shadow economy, thereby sidestepping tax collectors and regulators. "Why should I be honest about reporting my income when nobody else is? The politicians are only going to steal the tax money anyway," one Brazilian doctor told me. While Bolsonaro has promised a housecleaning of corrupt officials, this is a cry Brazilians have heard from every previous administration. In only the first half-year of his presidency, he has made several missteps, such as nominating one of his sons to be the new ambassador to the U.S., despite the congressman's lack of diplomatic credentials. A June poll found that 51 percent of Brazilians now lack confidence in Bolsonaro's leadership. Just this week, Brazil issued regulations that open a fast-track to deport foreigners who are dangerous or have violated the constitution. The rules published on July 26 by Justice Minister Sérgio Moro define a dangerous person as anyone associated with terrorism or organized crime, in addition to football fans with a violent history. Journalists noted that this new regulation had coincidental timing for an American journalist who has come under fire from Moro for publishing private communications of Moro's. Nevertheless, despite overselling his leadership skills, Bolsonaro has made some economic progress. With the help of congressional leader Rodrigo Maia, a bill is moving forward in congress for the restructuring of Brazil's generous pension system. Most Brazilians recognize the long-term value of such a change, which can save the government billions of dollars over the next decade. At merely the possibility of pension reform, outside investors have responded positively, and the São Paulo stock exchange has performed brilliantly, reaching an all-time high earlier this month. In efforts to boost the economy, Bolsonaro and Paulo Guedes have taken the short-term approach advocated by the Chicago school of economics championed by Milton Friedman, who claimed the key to boosting a slugging economy was to cut government spending. Unfortunately many economists, such as Nobel Prize winner Paul Krugman, disagree with this approach. They believe the most effective way to revive a slow economy is exactly the opposite, to spend more money not less. They say the government should be investing money in education and infrastructure projects, which can help put people back to work. Bolsonaro/Guedes have also talked about reducing business bureaucracy and revising the absurdly complex Brazilian tax system, which inhibits foreign and domestic business investment. It remains to be seen whether Bolsonaro has the political acumen to tackle this Godzilla-sized issue. Should Bolsonaro find a way to reform the tax system, the pension system, and curb the most egregious villains of political bribery and kickbacks – a tall order – his efforts could indeed show strong economic results in time for the next election in 2022. Meanwhile, some prominent leaders have already lost faith in Bolsonaro's efforts. The veteran of political/economic affairs, Joaquim Levy, has parted company with the president after being appointed head of the government's powerful development bank, BNDES. Levy and Bolsonaro butted heads over an appointment Levy made of a former employee of Lula's. When neither man refused to back down, Levy resigned his position at BNDES. Many observers believe Bolsonaro's biggest misstep has been his short-term approach to fixing the economy by loosening the laws protecting the Amazon rainforest. He and Guedes believe that by opening up more of the Amazon to logging, mining, and farming, we will see immediate economic stimulation. On July 28, the lead article of The New York Times detailed the vastly increased deforestation in the Amazon taking place under Bolsonaro's leadership. Environmental experts argue that the economic benefits of increased logging and mining in the Amazon are microscopic compared to the long-term damage to the environment. After pressure from European leaders at the recent G-20 meeting to do more to protect the world's largest rainforest, Bolsonaro echoed a patriotic response demanding that no one has the right to an opinion about the Amazon except Brazilians. In retaliation to worldwide criticism, Bolsonaro threatened to follow Trump's example and pull out of the Paris climate accord; however, Bolsonaro was persuaded by cooler heads to retract his threat. To prove who was in control of Brazil's Amazon region, he appointed a federal police officer with strong ties to agribusiness as head of FUNAI, the country's indigenous agency. In a further insult to the world's environmental leaders, not to mention common sense, Paulo Guedes held a news conference on July 25 in Manaus, the largest city in the rainforest, where he declared that since the Amazon forest is known for being the "lungs" of the world, Brazil should charge other countries for all the oxygen the forest produces. Bolsonaro/Guedes also have promised to finish paving BR-319, a controversial highway that cuts through the Amazon forest, linking Manaus to the state of Rondônia and the rest of the country. Inaugurated in 1976, BR-319 was abandoned by federal governments in the 1980s and again in the 1990s as far too costly and risky. Environmentalists believe the highway's completion will seal a death knoll on many indigenous populations by vastly facilitating the growth of the logging and mining industries. Several dozen heavily armed miners dressed in military fatigues invaded a Wajãpi village recently in the state of Amapá near the border of French Guiana and fatally stabbed one of the community's leaders. While Brazil's environmental protection policies are desperately lacking these days, not all the news here was bad. On the opening day of the 2019 Pan America Games in Lima, Peru, Brazilian Luisa Baptista, swam, biked, and ran her way to the gold medal in the women's triathlon. The silver medal went to Vittoria Lopes, another Brazilian. B. Michael Rubin is an American writer living in Brazil.

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