Cesarean section in four Rio de Janeiro Hospitals.

Data collected on maternity patients at four hospitals in Rio de Janeiro, Brazil, show that their rates of cesarean section vary considerably, ranging from less than 15% of all deliveries at the hospital serving women from the lowest socioeconomic group to over 80% at the one restricted to private patients. Virtually none of the conditions usually considered as indication for cesarean delivery were universally managed in this manner. On the other hand, in many instances, there was no recorded indication for abdominal delivery. While mortality and morbidity rates are low, exposure of mothers and infants to the additional risks associated with surgery for no apparently valid reason is unwarranted.