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The effect of increasing Women's autonomy on primary and repeated caesarean sections in Brazil.

Published version
Peer-reviewed

Change log

Authors

de Oliveira, Victor Hugo  ORCID logo  https://orcid.org/0000-0002-4737-7062
Lee, Ines 
Quintana-Domeque, Climent  ORCID logo  https://orcid.org/0000-0002-6626-6261

Abstract

Caesarean section (C-section) rates continue to rise globally. Yet, there is little consensus about the key determinants of rising C-section rates and the sources of variation in C-section rates across the world. While C-sections can save lives when medically justified, unnecessary surgical procedures can be harmful for women and babies. We show that a state-wide law passed in São Paulo (Brazil), which increased women's autonomy to choose to deliver via C-section even when not medically necessary, is associated with a 3% increase in overall C-section rates. This association was driven by a 5% increase in primary C-sections, rather than repeated C-sections. Since the law emphasizes women's autonomy, these results are consistent with mothers' demand being an important contributor to high C-section rates in this context.

Description

Keywords

caesarian sections, natural experiment, policy change, synthetic control, Brazil, Cesarean Section, Female, Humans, Mothers, Pregnancy, Unnecessary Procedures

Journal Title

Health Econ

Conference Name

Journal ISSN

1057-9230
1099-1050

Volume Title

Publisher

Wiley