Rising Caesarean Section Rates in the Czech Republic and Brazil - Determinants And Costs Estimation Analysis

The rising proportion of caesarean births beyond the World Health Organization 15% threshold level has been a worldwide trend consecutively creating an additional financial burden to health care systems. The Czech Republic used to report low Caesarean Section (CS) rates; nevertheless, since 2004, it has surpassed the recommended level. Currently, it belongs among countries with a 25 to 30% rate. On the contrary, Brazil has been the world's leading country in CS birth rates (57% of deliveries), reaching alarming numbers already in the 1980s. The aim of this paper is firstly to seek the reasoning behind significantly higher numbers of CS rates in Brazil compared to the Czech Republic since the millennia by explaining trends and mindset of social classes, and secondly to estimate extra costs related to a rising number of CS births in Brazil in comparison to the Czech Republic. Since public birth institutions in Brazil lack a decent public recognition, the low and growing middle-income class - characterized with medium/higher education and with a slightly higher average age of the mother at pregnancy - prefer CS deliveries (if affordable) whereas, high-income class mothers prefer to pay for natural births. Brazilian women with the highest education also tend to require natural birth due to more heightened awareness related to CS risks. Simultaneously, the occurrence of CS in the Czech Republic increases with education, reflecting more years spent studying, hence the last age of mothers-to-be. As per results of cost estimation, the extra expenditure related to CS in the Czech Republic for years 2000-2013 are relatively negligible (0.0564% of the Czech 2014 GDP); however, the total costs for the same year corresponds to 0.71% of Brazilian 2014 GDP. If managed to decrease the excess number of CS deliveries, these funds could be reallocated to other health fields, which lack capital support.