Women’s experiences of sterilisation in Brazil: negotiating reproductive discourses, institutional and intimate relationships, and contraceptive practices
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Date
25/11/2019Author
McKenna, Aoife Síle
Metadata
Abstract
The dramatic drop of the fertility rate in Brazil, from 6.2 births per woman in
1960 to 2.5 in 1996, has been attributed to women’s increasing use of
sterilisation. Despite the fact that sterilisation was illegal, Brazil had the
second highest rate in the world in 1996, at 40.1%. Political concerns
regarding the abuse of the operation led to the legalisation of sterilisation in
1997 to provide regulation of the procedures. Subsequently, rates of
reversible contraception have increased, and sterilisation rates dropped to
21.4% by 2013. Sterilisation in Brazil is thus a useful case study to examine
how changing socio-legal contexts can influence experiences or
understandings of this contraceptive technology.
This research is based on semi-structured interviews conducted in 2013 with
35 women from a variety of socio-economic and ethnic backgrounds in Rio
de Janeiro. This thesis is informed by a sociological perspective on health
technologies that takes account of the social context and of lay users’ views
of their experiences. Several different domains of social life that have an
influence on participants’ understandings of sterilisation are thus examined,
including: wider reproductive discourses, family and intimate relationships,
the medical institution within which contraception is provided, and prior
experiences of reversible contraceptive technologies.
The thesis demonstrates the importance of examining sterilisation as a
socially-mediated practice. At the institutional level, my analysis illustrates
how women navigate the shifting ambiguous socio-legal context, as well as
the systemic barriers to healthcare, when accessing sterilisation. The
influence of intersections of gender, race and class are highlighted in this
process, and is evident in women’s experiences of family and intimate
relationships. At the embodied and individual level, the significance of the
design of contraceptive technologies is emphasised, as well as women’s
prioritisation of their own emotional and physical wellbeing and sexual
pleasure. Furthermore, the analysis highlights how reproductive discourses
intersect with cultural notions of family ideals and everyday practices, to
influence both decisions about and understandings of sterilisation. Overall,
the thesis illustrates how sterilisation is a socially mediated practice that
varies dependent on macro contexts of cultural reproductive discourses, as
well as institutional, interactional and individual levels.