Can the cesarean section rates be reduced in Brazil? Results of a Franco-Brazilian pilot study
Seance of wednesday 06 may 2026 (Chirurgie Gynécologique)
DOI number : 10.26299/x44w-gg19/emem.2026.19.05
Abstract
Cesarean section without clinical indication constitutes a major public health issue in Brazil. In 2024, approximately 60% of births were delivered by cesarean section. Fear of labor pain is identified as the main reason why women request a cesarean delivery. In contrast, the rate of epidural analgesia during childbirth is approximately 12%.
In France, cesarean section rates have remained around 20% for the past 30 years, while epidural analgesia rates are high, reaching 84% in 2021.
A technical and scientific cooperation between France and Brazil began in 2022 with the aim of expanding the use of epidural analgesia during childbirth in two Brazilian pilot maternity hospitals, in order to improve maternal comfort and reduce cesarean section rates in these institutions.
The results obtained up to February 2026 show an increase in the use of epidural analgesia in both healthcare units, rising from 2.1% in 2021 to 15.2% in February 2026 in the low-risk maternity unit, and from 3.4% in 2021 to 26.1% in November 2025 in the high-risk maternity unit. Cesarean section rates did not show significant variation in either maternity hospital.
Further efforts will be necessary for epidural analgesia to contribute to reducing cesarean section rates. Government initiatives have also been implemented to establish a public health policy that humanizes obstetric care and guarantees women access to epidural analgesia as an effective right.
In France, cesarean section rates have remained around 20% for the past 30 years, while epidural analgesia rates are high, reaching 84% in 2021.
A technical and scientific cooperation between France and Brazil began in 2022 with the aim of expanding the use of epidural analgesia during childbirth in two Brazilian pilot maternity hospitals, in order to improve maternal comfort and reduce cesarean section rates in these institutions.
The results obtained up to February 2026 show an increase in the use of epidural analgesia in both healthcare units, rising from 2.1% in 2021 to 15.2% in February 2026 in the low-risk maternity unit, and from 3.4% in 2021 to 26.1% in November 2025 in the high-risk maternity unit. Cesarean section rates did not show significant variation in either maternity hospital.
Further efforts will be necessary for epidural analgesia to contribute to reducing cesarean section rates. Government initiatives have also been implemented to establish a public health policy that humanizes obstetric care and guarantees women access to epidural analgesia as an effective right.