A mother giving birth naturally.

Navigating Childbirth: Are We Intervening Too Much?

Lena Voss in Health & Wellness June 2025 • 4 min read.

"A Deep Dive into Obstetric Interventions and Natural Birth Practices in Brazil"

Childbirth, a natural and transformative process, has increasingly become subject to medical interventions. While some interventions are crucial for managing complications and ensuring the safety of both mother and child, the rising rates of routine obstetric procedures have sparked debate among healthcare professionals and expectant parents alike.

In Brazil, a country known for its high rates of Caesarean sections, a recent study published in the Cadernos de Saude Publica sheds light on the prevalence of obstetric interventions during labor and childbirth among low-risk women. This research, titled “Obstetric interventions during labor and childbirth in Brazilian low-risk women,” reveals a concerning trend: a significant overuse of medical procedures, often without clear evidence-based justification.

This article aims to break down the key findings of the study, explore the implications for maternal and infant health, and discuss potential strategies for promoting more natural, evidence-based childbirth practices. We will examine the specific interventions that are most commonly overused, compare Brazil's practices with those of other countries, and offer practical advice for expectant parents seeking to navigate the complexities of modern childbirth.

What the Data Reveals: Common Obstetric Interventions in Brazil

The study, led by Maria do Carmo Leal and her team, analyzed data from the “Birth in Brazil” survey, a national hospital-based study conducted between 2011 and 2012. The researchers focused on low-risk women, defined as those without pre-existing conditions like hypertension or diabetes, and with uncomplicated pregnancies.

The findings revealed that while certain beneficial practices, such as eating during labor, mobility, and the use of non-pharmacological pain relief, were underutilized, several interventions were surprisingly common:

Lithotomy Position: Used in over 90% of vaginal births, despite evidence suggesting that upright or lateral positions can be more beneficial for both mother and baby.
Episiotomy: Performed in over half of vaginal births, despite clinical guidelines recommending against routine use.
Uterine Fundal Pressure (Kristeller Maneuver): Applied in over a third of vaginal births, a practice that can be risky and is not generally recommended.
Oxytocin Drips and Amniotomy: Used in approximately 40% of cases to speed up labor.

The study also highlighted disparities in care, with women in public hospitals and those with lower levels of education more likely to experience certain interventions. These findings raise important questions about the standardization of care and the potential for overuse of medical procedures, even in low-risk pregnancies.

Empowering Informed Choices: Towards a More Natural Approach

The findings from the Birth in Brazil survey underscore the need for a shift towards a more evidence-based, humanized approach to childbirth. By promoting best practices, reducing unnecessary interventions, and empowering women to make informed choices, we can improve the health and well-being of mothers and newborns in Brazil and beyond. It is essential to have open conversations with your healthcare provider about your preferences, to seek information from reliable sources, and to advocate for the kind of birth experience that aligns with your values and beliefs.

About this Article -

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Everything You Need To Know

What are the key obstetric interventions commonly used in Brazil during childbirth?

The study, which was based on the “Birth in Brazil” survey, highlights several common interventions. These include the use of the Lithotomy Position in over 90% of vaginal births, Episiotomy performed in over half of vaginal births, Uterine Fundal Pressure (Kristeller Maneuver) applied in over a third of vaginal births, and Oxytocin Drips and Amniotomy used in approximately 40% of cases. These interventions were observed in low-risk women, raising concerns about their overuse without clear, evidence-based justification.

Why is the overuse of the Lithotomy Position concerning during childbirth?

The Lithotomy Position, used in over 90% of vaginal births in the study, is concerning because evidence suggests that upright or lateral positions can be more beneficial for both mother and baby. These alternative positions can potentially improve the birthing process and reduce the need for further interventions. By contrast, the Lithotomy Position may not be optimal for promoting natural childbirth.

What is the significance of the “Birth in Brazil” survey, and who was studied?

The “Birth in Brazil” survey, a national hospital-based study conducted between 2011 and 2012, provides critical data on obstetric interventions. The researchers, led by Maria do Carmo Leal and her team, focused on low-risk women, defined as those without pre-existing conditions like hypertension or diabetes and with uncomplicated pregnancies. The survey's findings reveal important trends in the use of medical procedures during labor and childbirth in Brazil.

What are the potential implications of frequently using Uterine Fundal Pressure (Kristeller Maneuver) during childbirth?

The Uterine Fundal Pressure (Kristeller Maneuver), applied in over a third of vaginal births, carries potential risks and is generally not recommended. It involves applying pressure to the mother's abdomen to help deliver the baby, but this practice can lead to complications. The study's findings suggest a need to reassess the use of this intervention and to promote safer, evidence-based practices.

How can expectant parents navigate childbirth and promote more natural, evidence-based practices in Brazil?

Expectant parents can promote a more natural, evidence-based approach to childbirth by having open conversations with their healthcare providers about their preferences. They should seek information from reliable sources and advocate for a birth experience that aligns with their values and beliefs. It's also important to understand the implications of various interventions, such as the Lithotomy Position, Episiotomy, Uterine Fundal Pressure (Kristeller Maneuver), and Oxytocin Drips and Amniotomy, and to make informed decisions based on evidence and personal choice.