Medicalization of childbirth: the meanings attributed by the literature on childbirth care in Brazil

Abstract This study analyzes the meanings attributed to the concept of the medicalization of childbirth from a narrative review of the literature in national journals published between 2000 and 2017. It is based on the more general concept of medicalization – understood as the process by which medicine broadens and consolidates its area of activity in the various sectors of society – and the different formulations of the concept conceived by twentieth-century scholars. Five categories were created that related the medicalization of childbirth with interventions, professional dispute, violation of the rights of pregnant women, the birth scenario, and the impact of the medicalization of society. In the first four categories there is a predominance of meanings that explore the interface between medicalization and humanization, considered two analytical super categories, with a predominance of a critique of the medicalized model. Setting aside this analysis model, the medicalization of childbirth category as a reflection of the medicalization of society focuses on a sense of medicalization of childbirth as part of a broader process involving different actors who are part of the care process, pointing to a possibility of more in-depth analysis in which it considers the complex connection between modern health and society.

摘要 本研究通过对2000年至2017年间本国学术期刊刊载的文献开展叙事性综述，剖析了分娩医学化（medicalization of childbirth）这一概念的内涵。本研究以更广义的医学化（medicalization）概念为基础——医学化被定义为医学在社会各领域拓展并巩固其活动边界的过程——同时吸纳了20世纪学者对该概念提出的不同阐释框架。研究构建了五大分类维度，将分娩医学化分别与医疗干预、专业争端、孕产妇权利侵害、分娩场景以及社会医学化的影响相关联。在前四类分类中，研究主要探讨了医学化与人性化这两大分析性超级范畴之间的交叉界面，且整体呈现出对医学化分娩模式的批判倾向。跳出前述分析框架，将分娩医学化视为社会医学化映射的第五类分类，则聚焦于将分娩医学化视作涵盖照护流程中多元参与主体的更广泛社会进程的一部分，这为探究现代卫生体系与社会之间的复杂关联提供了更具深度的分析路径。