Phase I: 122 semi-structured, in-depth interviews with patients who are pregnant and/or had given birth within the past 10 years
Phase II: Ethnographic Observation of the OB/GYN ward of a Region III public hospital for 27 births
•27 accompanied births in 75 hours of physician and nurse shadowing
•62.96% observed cesarean rate
•Cesareans were due to prolonged labor, previous cesareans, and breech presentation.
•Officially recorded hospital cesarean rate for 2014: 36.7%
Female OB/GYN: “Do you want the truth or the lie?” (with respect to the reason for cesarean overuse in the DR), “Both”, I responded. “The truth is fear in the administration” (of maternal and infant mortality). “And the lie?” “The lie is fetal distress.”
Male General Surgeon: “Is it logical for a patient to suffer ten hours of pain?” “Well, it depends”, I said. “What is the doctor’s job?” “To treat the person’s illness”, I said. “No, no, no. The doctor’s job is to alleviate the patient’s suffering. It’s not logical for a patient to suffer ten hours of pain.” I then explained to him that this logic only works if you consider vaginal and cesarean outcomes to be the same. He said, “But the patient nowadays doesn’t suffer with a cesarean. That’s why we have pain killers.”