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Requests for cesarean deliveries: The politics of labor pain and pain relief in Shanghai, China

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  • Wang, Eileen

Abstract

Cesarean section rates have risen dramatically in China within the past 25 years, particularly driven by non-medical factors and maternal requests. One major reason women request cesareans is the fear of labor pain, in a country where a minority of women are given any form of pain relief during labor. Drawing upon ethnographic fieldwork and in-depth interviews with 26 postpartum women and 8 providers at a Shanghai district hospital in June and July of 2015, this article elucidates how perceptions of labor pain and the environment of pain relief constructs the cesarean on maternal request. In particular, many women feared labor pain and, in a context without effective pharmacological pain relief or social support during labor, they came to view cesarean sections as a way to negotiate their labor pain. In some cases, women would request cesarean sections during labor as an expression of their pain and a call for a response to their suffering. However, physicians, under recent state policy, deny such requests, particularly as they do not view pain as a reasonable indication for a cesarean birth. This disconnect leads to a mismatch in goals for the experience of birth. To reduce unnecessary C-sections, policy makers should instead address the lack of pain relief during childbirth and develop other means of improving the childbirth experience that may relieve maternal anxiety, such as allowing family members to support the laboring woman and integrating a midwifery model for low-risk births within China's maternal-services system.

Suggested Citation

  • Wang, Eileen, 2017. "Requests for cesarean deliveries: The politics of labor pain and pain relief in Shanghai, China," Social Science & Medicine, Elsevier, vol. 173(C), pages 1-8.
  • Handle: RePEc:eee:socmed:v:173:y:2017:i:c:p:1-8
    DOI: 10.1016/j.socscimed.2016.11.032
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    References listed on IDEAS

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    1. LoCicero, Alice Katherine, 1993. "Explaining excessive rates of cesareans and other childbirth interventions: Contributions from contemporary theories of gender and psychosocial development," Social Science & Medicine, Elsevier, vol. 37(10), pages 1261-1269, November.
    2. Long, Qian & Klemetti, Reija & Wang, Yang & Tao, Fangbiao & Yan, Hong & Hemminki, Elina, 2012. "High caesarean section rate in rural China: Is it related to health insurance (New Co-operative Medical Scheme)?," Social Science & Medicine, Elsevier, vol. 75(4), pages 733-737.
    3. Sakala, Carol, 1993. "Midwifery care and out-of-hospital birth settings: How do they reduce unnecessary cesarean section births?," Social Science & Medicine, Elsevier, vol. 37(10), pages 1233-1250, November.
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    Cited by:

    1. Xiu Zhu & Yan Wang & Hong Zhou & Liqian Qiu & Ruyan Pang, 2019. "Adaptation of the Childbirth Experience Questionnaire (CEQ) in China: A multisite cross-sectional study," PLOS ONE, Public Library of Science, vol. 14(4), pages 1-16, April.
    2. Surana, Mitul & Dongre, Ambrish, 2018. "Too much care? Private health care sector and surgical interventions during childbirth in India," IIMA Working Papers WP 2018-11-01, Indian Institute of Management Ahmedabad, Research and Publication Department.

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