
This article was exclusively written for The European Sting by Ms. Luiza Souza da Rocha Matos, a Brazilian medical student at the UNIME University. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.
Since 1985, the World Health Organization (WHO) has stated that cesarean section rates above 10–15% do not lead to better maternal or neonatal outcomes. Although cesarean delivery can be life-saving when medically indicated, its overuse may expose women and newborns to unnecessary risks, as with any surgical procedure. Despite this, childbirth has become increasingly medicalized worldwide, and Brazil illustrates this trend clearly, having surpassed 50% cesarean section rates in the early 2010s and maintaining even higher levels in recent years.
Understanding this scenario requires looking beyond clinical factors. For generations, childbirth in many communities has been supported by traditional midwives and collective knowledge systems, where birth is understood as a physiological and social event rather than a strictly medical procedure. These practices are deeply rooted in territorial and cultural structures, but they are increasingly under threat, as environmental changes such as deforestation, land conflicts, and the displacement of traditional populations progressively disrupt them. In addition, broader processes of urbanization are reshaping how childbirth is understood and managed. As societies become more urbanized and healthcare systems more medicalized, traditional forms of care are gradually replaced by institutional models, often leading to a greater reliance on surgical interventions.
In this context, the Brazilian case helps illustrate how environmental change, social transformation, and medicalization are interconnected in shaping women’s health. In regions where Indigenous and traditional communities remain more present, vaginal birth is still more common, even if not within levels recommended by the WHO. However, cultural perceptions of childbirth are rapidly shifting. Many women have come to view vaginal birth as outdated or even unsafe, and as communities lose access to their territories or are forced into urban settings, the social networks that sustain traditional birth practices begin to erode.
It is important to emphasize that expanding access to healthcare, including in remote and underserved areas, is essential and can significantly improve maternal and neonatal outcomes. The problem does not lie in the presence of medical care, but in how childbirth is perceived. As cesarean sections become associated with modernity, safety, and technological advancement, they may be viewed as equivalent or even superior to vaginal birth. However, this is not the case. Cesarean delivery is a surgical procedure associated with higher risks when performed without clear medical indication, which is why the WHO recommends that its use be limited.
Efforts to expand healthcare access should not come at the cost of erasing ways of life that have long sustained both communities and ecosystems. The preservation of traditional birth practices is intrinsically linked to the protection of territories, forests, and social structures that support them. Rather than replacing these systems, it is both possible and necessary to build models of care that are evidence-based and culturally grounded. In this sense, advancing women’s health in the context of climate change requires not only medical solutions, but also a commitment to sustainability and the coexistence of different ways of knowing and caring.
About the author
Luiza Souza da Rocha Matos is a Brazilian medical student at the UNIME University and a trained birth doula born on April 30, 2003. She is affiliated with the International Federation of Medical Students Associations (IFMSA) since 2025, and currently acts as the Local Publications and Research Director. Her academic interests include public health and epidemiology, women’s health and maternal care. Her perspective on childbirth has been shaped by her training as a doula, particularly through learning from women engaged in traditional and culturally rooted birth practices.
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