[Cesarean section in Brazil: incidence, trends, causes, consequences and suggestions for change]

The authors analyse the current cesarean section situation in Brazil. In the last decade it has reached extremely high levels of incidence, higher than any other country. Social-economic and regional differences are established through the available national data on the cesarean section incidence. There is a higher incidence on wealthier regions and women. The factors influencing this high incidence, including socio-cultural, obstetric care organization, legal and institutional ones are also considered. Special attention is given to the problem of female surgical sterilization which is forbidden in the country and is performed through inadequate indication of a cesarean section. Consequences for maternal and perinatal morbidity and mortality, the effects on population fertility and extra public expenses are considered. Interventions and attitude changes are proposed at several levels to reverse this increasing tendency of cesarean section incidence in the country.