STERILIZATION, CESAREANS AND CONTRACEPTIVE CHOICE

描述：在巴西，甚至比在美国更有 手术避孕和分娩的使用都在激增。 的 研究人员的目的是区分和权衡影响， 导致巴西医生进行手术，巴西妇女要求， 在剖腹产分娩期间进行绝育。 这些问题涉及： 医生的便利和报酬;妇女对手术的偏好 分娩和避孕;以及重复剖宫产的发生率， 据推测，这使得妇女在怀孕期间子宫破裂的风险很高。 未来的怀孕，并导致选择一个不可逆的方法。 到 评估这些替代影响，他们将采用一种研究设计， 结合了服务的提供者和消费者，并深入研究了 在定期生育率调查中没有发现的问题， 避孕做法，如人口与健康部开展的做法。 调查人员将采访产科医生，了解他们的培训情况， 它们适用于决定交付类型的标准， 和采访妇女，了解她们的经验，知识， 和偏好。 他们还将进行一项前瞻性研究， 母亲们会在怀孕早期接受采访， 提供和采访高级医生的历史， 手术避孕和分娩的经验。 的 研究将在巴西的四个州进行， 巴西国内剖宫产率的变化， 妇女绝育在所有避孕措施中所占的比例， 在剖腹产手术中进行绝育的比例 路段 该项目将有助于目前关于自然的辩论 在生育率迅速下降期间采用避孕方法的过程 并且，第一次强调这样的过程是如何出错的， 一个社会将被锁定在既不安全， 性价比

DESCRIPTION: In Brazil, even more so than in the United States there has been an upsurge in use of both surgical contraception and delivery. The investigators' aim is to distinguish among and weigh the influences that lead Brazilian doctors to perform, and Brazilian women to demand, sterilizations during a cesarean section delivery. These have to do with: the doctor's convenience and remuneration; women's preferences for surgical delivery and contraception; and the incidence of repeat cesarean sections, which supposedly place women at high risk of rupturing their uterus during a future pregnancy and lead to the choice of an irreversible method. To assess these alternative influences, they will employ a research design that incorporates both the providers and consumers of services, and delves into subjects that are not found in regular surveys of fertility and contraceptive practice such as have been carried out by DHS. The investigators will interview obstetricians regarding their training and the criteria they apply to decisions regarding type of delivery and sterilization; and interview women regarding their experience, knowledge, and preferences. They will also carry out a prospective study in which mothers would be interviewed early in pregnancy and then after their delivery and interview senior medical practitioners regarding the history of surgical contraception and delivery in their medical community. The research will be carried out in four states of Brazil chosen to capture the variation that exists within Brazil in the rate of cesarean sections, the proportion of all contraception accounted for by female sterilization, and the proportion of sterilizations that are performed during cesarean sections. This project will contribute to current debates about the nature of the process of contraceptive adoption during a rapid fertility decline and, for the first time, highlight how such a process can go wrong, leading a society to become locked-in to technologies that are neither safe nor cost-effective.