Physicians and the excess of cesarean sections in Brazil

The present study discusses the physicians’ role associated with high cesarean section rates in Brazil. The discussion is based on the available literature on the subject as well on Ludwick Fleck and Robbie Davis-Floyd approach. We suggest a hypothesis for the problem that involves financial benefits, convenience and changes in clinical ability (that favors the specialization in C-sections and decrease the clinical ability to fix dystocias and manage the vaginal birth) that became associated with a technocratic paradigm of birth care. This model of care reinforces itself to further increase the C-section rates. We advocate the need to address the problem and suggest evaluation and professional accreditation through continued education and publication of C-section rates per institution and per surgeon, and also institutional and economic changes to revert secondary gains by the professionals who sustain the High cesarean section rates.