Name: ANA CAROLINA JULIO DA SILVA ANDRADE
Publication date: 24/04/2019
Advisor:
Name |
Role |
|---|---|
| CÉSAR AUGUSTO TURETA DE MORAIS | Advisor * |
Examining board:
| Name |
Role |
|---|---|
| ALFREDO RODRIGUES LEITE DA SILVA | Internal Examiner * |
| CÉSAR AUGUSTO TURETA DE MORAIS | Advisor * |
| LETICIA DIAS FANTINEL | Internal Examiner * |
Summary: This PhD. dissertation aims to analyze how obstetrical practice organization motivates
the practitioners (not) to opt for a humanized normal birth, contributing to the
maintenance and/or the change of giving birth as a social practice. I used the practice
ontoepistemology according to Schatzki and I conducted a Practice-Based Study in a
Brazilian public maternity. Birth is revealed as the intersection of three practices:
medical practices, maternal/paternal practices and healthcare management practices.
In this overlapping of practices a social movement emerges in favor of changing
practices and a more humanized maternity care. One of the goals of this movement
is to reduce high cesarean rates. My argument is that maintenance and change
constitute a single process of "maintaining-changing"; which emphasizes that these
phenomena have a recursive relation. The first theoretical contribution of this
dissertation is the explicit and direct analysis of obstetrical practices changing process.
The second contribution is the analysis of "maintaining-changing" practices as a single,
simultaneous and recursive process. The third contribution is to overcome the
apparent dichotomy between "maintaining" and "changing" phenomena. In addition,
this study reinforces the understanding of "changing" as not an uncommon episode,
but as a constitutive element of organizational/social life. This dissertation also
reaffirms that "micro" and "macro" phenomena are mutually constituted, once changing
process results from a interdependent relationship between local practices and their
broader contexts. Finally, in practical terms, this dissertation can contribute to public
policies that understand obstetrical practices beyond medical techniques, taking into
account its historical-social context. The second contribution is the analysis of a
seemingly punctual health issue (giving birth) in a wider way. Thus, other health issues
could be analyzed in the same way, since problems such as childhood obesity are also
part of a practice nexus.
