More than 37% of the 75,468 deliveries carried out in 2021 were by caesarean section, announced this Monday the Health Regulatory Entity (ERS), which accounted for 321 fetal and neonatal deaths in mainland Portugal in the same year.
“In the National Health Service (SNS) hospitals, the percentage of cesarean sections in total births corresponded to 30.7%, contrasting with the reality of private and social hospitals, where the percentage of cesarean sections rose to 65.9% of deliveries. carried out in these establishments”, indicates an ERS monitoring of the activity of obstetrics health care providers.
According to the document, the most representative type of cesarean section in private and social hospitals was the scheduled (49.0%), while in public hospitals urgent cesarean sections were the most frequent (53.9%).
Of the 75,468 births carried out in 2021, 60,759 were in public hospitals and the remaining 14,709 took place in units outside the SNS.
The regulator’s analysis also indicates that, in that year, 321 fetal deaths and neonatal (up to 28 days of life) in mainland Portugal, a ratio of deaths per birth of 0.42%, higher in the regions of Lisbon and Vale do Tejo (0.52%) and Alentejo (0.45%).
As for maternal deaths, ERS found that, in 2021, there were three in mainland Portugal.
As for accessibility to the 61 public and private birthing blocks, ERS adds that around 91% of women of childbearing age have a medium or high level of access to these medical services, but 8% of this female population still faces “a low level of access or at an excessive distance”more than a 60-minute journey from your residence.
“Considering only the offer of the 39 birth centers of the SNS, the population with low access or at an excessive distance changes very little, but the population with a high level of access reduces from 64% to about 30%, with the health regions of the North, Center and Lisbon and Vale do Tejo undergoing the greatest changes”, warns, however, the regulatory authority.
In terms of offer, of the total of 61 establishments that provide medical and nursing services in obstetrics and neonatology, the majority (63.9%) are from the SNS, with emphasis still being placed, among the establishments not integrated into the SNSthe highest concentration (72.7%) in the North region.
Of the total of 75,468 deliveries performed, 80.5% took place in SNS establishments and 43.0% took place in Lisbon and the Tagus Valley and 34.2% in the North, while at the opposite extreme is Alentejo, which represented only 3.2% of all births in 2021.
ERS adds that the monitoring now released is part of a more comprehensive and in-depth analysis that it is developing in the field of obstetrics, covering access to maternal-fetal surveillance care and to health care services. obstetrics emergency in the SNS.
Three private parties only performed deliveries by cesarean section
In the same year, there were three private hospitals that only performed cesarean deliveries. These units are all located in the North region of the country.
According to data sent to the Observer by ERS, at the Hospital Particular de Viana do Castelo; at Boa Nova, in Matosinhos; and at the Private Hospital of Vila Real no normal delivery was performedl. These are also the hospitals where fewer births, regardless of the method, took place.
In total, there were 31 caesarean sections at the private hospital in Viana do Castelo, 23 in Matosinhos and 17 in Vila Real. And it is about cases like these that Fernando Araújo, executive director of the SNS, has been criticizing.
“I should remind you that there are private birthing blocks that do 40 to 50 births a year, eventually one birth a week and with 100% cesarean rates. I have doubts if are they birth wards or are they surgical wardswhich is quite different”, said the doctor in an interview with SIC at the beginning of the year.
There is only one private hospital whose percentage of caesarean sections is in line with or below that recorded in general in the SNS: Hospital de Cascais – Lusíadas (27.6%). No public hospital has percentages as high as the private and social sector: the highest values are those of Hospital Pêro da Covilhã, which belongs to the Centro Hospitalar Cova da Beira and which performed 46.6% of cesarean sections in 2021.
