Abstract
ObjectiveThe aim of this paper is to analyse the evolution of birth conditions in Portugal and to establish a correspondence between maternity care and the socio-economic characteristics of new mothers. MethodsA multivariate quantitative analysis (Multiple Correspondence Analysis and Cluster Analysis) was used, based on official quantitative data from different surveys. ResultsThere is a consistent trend to a technocratic model of birth in the Portuguese context, where socio-economic characteristics appear to influence fertility rates and birth conditions.The evolution of birth conditions in Portugal reveal the institutionalisation of birth, with a strong presence of doctors, a higher frequency of births on certain weekdays, an increase in the proportion of births in private hospitals and an increase in the frequency of caesarean sections. There is an association between higher social status and more medicalised forms of assistance in childbirth. Women with higher levels of education, aged between 30 and 39years and who were married tended to be distinguished from the population of Portuguese women as a whole by three factors: birth in a hospital, the standardisation of pregnancy duration and the presence of a doctor at the birth. Women’s educational and professional status also appears to influence their adoption of alternative models of birth, however, such as home birth. DiscussionLimiting the study of childbirth to its medical aspects leaves important dimensions out of the analysis: women’s perception of birth-related risks associated with the medicalised offer of maternity care, and the implications of this childbirth paradigm for health outcomes and for future care.
Highlights
In the twenty first century, human birth involve risks, as it ever did
Objective: The aim of this paper is to analyse the evolution of birth conditions in Portugal and to establish a correspondence between maternity care and the socio-economic patterns of the Portuguese mothers
The importance of studying the Portuguese case is based on the fact that previous studies focused primarily on the social framework, results and consequences of fertility, as well as in the assumption that the two aspects of birth we propose to consider in this study – the childbirth conditions and the profile of population who have children – are associated
Summary
In the twenty first century, human birth involve risks, as it ever did. the context of modernity has helped to change and complexify knowledge, assessment and management of risks concerning childbirth [1].In the wider context of the medicalisation of society [2,3], the reconceptualisation of risk and birth – which has come to be defined as a risk process – has legitimised the transfer of a social to a medical approach in concern to childbirth [4]. The medicalised and institutionalised model of birth care and medical assistance in accordance to a technocratic model of birth [7], is defined by a new personal and social relationship with the body, mediated by the doctor and the use of technology This process is presented as conforming to social norms and, simultaneously, as a reflexive process based on risk information availability and management, relationships built on trust, and the integration of pregnancy and birth into identity construction – elements that contribute to decision-making [8,9,10]. It is described as a normalised process in the sense that women or parents do not associate the technological and medical intervention with the notion of an unnatural procedure [11]
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