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Are Brazilian women really choosing to deliver by cesarean?

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  • Hopkins, Kristine
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    Abstract

    Brazil has among the highest cesarean section rates in the world, with 36% of women in the country delivering surgically. Women, especially those who deliver in private hospitals with cesarean rates in the 80-90% range, are often portrayed as actively choosing to deliver surgically. Doctors typically promote this view, also common in the popular understanding of the phenomenon, that it is women's demand for a cesarean that is behind the high rates. Academic analyses tend to present a more balanced view with doctors' motives for wanting to perform cesareans included alongside descriptions of women's motives for the procedures. What is typically missing from such analyses is a discussion of the power differences between women and doctors. Doctors clearly have more decision-making power in the hospital birthing situation, and their medical expertise and authority is often marshaled to convince a woman to "choose" a cesarean. Using data collected from a postpartum survey, participant observation in hospital obstetrics wards, and in-depth interviews, I offer evidence which refutes many of the hypotheses associated with why women might prefer to deliver by cesarean. I also show that the majority of women surveyed in two cities in Brazil, particularly first-time mothers, do not seek to deliver by cesarean. Through an analysis of conversations between doctors and women during labor and delivery, and through women's narratives of their delivery experiences, I also show some of the mechanisms that doctors use in order to induce so-called demand for surgical delivery and argue that they are very active participants in the ongoing construction of the culture of cesarean section in Brazil.

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    File URL: http://www.sciencedirect.com/science/article/B6VBF-40B2BYM-8/2/19674499cc1545022dd0d970d5bc92d2
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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 51 (2000)
    Issue (Month): 5 (September)
    Pages: 725-740

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    Handle: RePEc:eee:socmed:v:51:y:2000:i:5:p:725-740

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    Related research

    Keywords: Cesarean section Vaginal delivery Doctor-patient interactions Brazil;

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    Cited by:
    1. Kabakian-Khasholian, Tamar & Kaddour, Afamia & DeJong, Jocelyn & Shayboub, Rawan & Nassar, Anwar, 2007. "The policy environment encouraging C-section in Lebanon," Health Policy, Elsevier, vol. 83(1), pages 37-49, September.

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