Restriction of Sterilization in Brazil

Box 23

In Brazil, while the right to reproductive health is legally protected, some procedural barriers restrict its exercise. Surgical contraception cannot be performed except when it is discovered to be necessary during another operative procedure.

The effect is to force women who desire sterilization after their current pregnancy to undergo unnecessary Caesarian sections rather than routine deliveries, since a history of Caesarian sections is accepted as medical grounds for sterilization (and sterilization can be performed inconspicuously at the same time). This imposes a significant health risk and higher costs. It has led to Caesarian sections being performed for almost one third of all deliveries, from under 20 per cent for low-income women to almost 60 per cent among women in high-income families.

The incidence of the procedure exceeds the level in the United States, where physicians have been accused of unnecessary use. The common use of Caesarian sections also creates an invitation to abuse. In the late 1980s, there were reports of surgical sterilizations performed on poor women who had undergone Caesarian deliveries, without their full informed consent. Monitoring can ensure that such practices are eliminated.

Source: Dixon-Mueller, Ruth. 1993. "Population Policy and Women's Political Action in Three Developing Countries." Population Policy and Women's Rights: Transforming Reproductive Choice, Chapter 4, pp. 87-88. Westport, Connecticut, and London: Praeger.