Women, Doctors, and Cesareans: The Construction of Normal Birth as "Risky" and the Medicalization of Birth in Brazil

Alessandra S. Chacham, Pontifícia Universidade Católica de Minas Gerais

In this work we investigate the reasons for the high rates of cesareans in Brazil, especially in private hospitals. We interviewed 18 obstetricians and 60 women who had given birth in the year of 1998 (30 in a public hospital and 30 in private hospitals), to understand their perceptions and preferences regarding the process of birth. Our data suggest that as result of the process of medicalization of birth in Brazil there is a growing perception of normal births as always more risky than cesareans, seen as innocuous. This perception seems to make easier for doctors to indicate a cesarean and for women to accept it, especially in the private sector. Also, we discuss as the current Brazilian obstetric assistance model (in which obstetricians are the sole responsible for assisting women during pregnancy, labor and birth), seems to reinforce the establishment of a more interventionist, technology-based kind of obstetric practice.