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Chapter 11 - Choice in Childbirth, Agency and Collective Action

Cesarean Sections and Birth Plans in Brazil

Published online by Cambridge University Press:  23 November 2023

Nick Hopwood
University of Technology, Sydney
Annalisa Sannino
Tampere University, Finland
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This chapter explores two experiences in which transformative agency and the elaboration of innovative mediating artifacts contributed to change in childbirth care in Brazil. In the first case, we analyze how an organized group of women built cultural tools to expose the excess of cesarean sections in the private health sector, leading to change in regulatory policy. In the second case, we analyze the elaboration of an institutional birth plan model in a formative intervention inspired by the Change Laboratory methodology. Both experiences can be understood as efforts to promote social participation and informed choice, using mediating artifacts to foster agency. The processes ignited by them are also analyzed by the perspective of pedagogy of autonomy as proposed by Freire, in the sense that women are able to build knowledge and act on that knowledge in a meaningful and effective way.

Agency and Transformation
Motives, Mediation, and Motion
, pp. 265 - 288
Publisher: Cambridge University Press
Print publication year: 2023

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