En strid på kniven? : Argument och aktörer i den svenska kejsarsnittsdebatten 1998-2003

• Sweden as well as many other Western countries has experienced a three-fold increase in the use of sectio caesaria during the last three decades. This paper investigates how the increase was described and explained in the Swedish press 1990-2003 by analyzing the five largest daily newspapers. The paper further seeks to explain why the rise in sectio was regarded as a problem and why certain perceptions became dominant. In order to do this two different theories were chosen. Firstly, a theoretical framework for ‘birth’ as a biologically as well as socially conditioned phenomenon was adapted. Secondly, discourse analysis was applied in order to distinguish the dominant perceptions expressed in the media. Another important element of this paper is the extensive reference to the historical development of the Swedish delivery care, which is used to shed light over the findings of the empirical analysis. A division into four different phases of the development of the Swedish delivery care 1870-2003 is proposed and has proven useful to explain a number of perceptions of the debate. The empirical research showed that media paid attention to the increase in the sectio rate from 1998 onwards, and that the rise was generally described as a problem. Moreover, it was often seen as related to women requesting sectios, which in turn was usually described as being caused by fear of birth. The remedy most commonly referred to was to offer help to women with fear of birth. The analysis of the articles stands in stark contrast to statistics. Sectios granted to women on their own request—so-called “humanitarian” sectios—represented only a small part of all sectios. Although humanitarian sectios had the highest increase of all different medical indications, their total impact on the number of sectio was limited to 10 % of the total rise and therefore contributed to the overall increase in only a limited way. The initial analysis thus yields a central question: why did the debate focus on the humanitarian sectios on the request of women, when in fact these sectios accounted for only a small part of the total increase? The hypothesis put forward here is that women requesting a sectio transgressed the predominant cultural definition of birth—in short, “vaginal delivery is best”—by introducing an element of consumer demand. The paper has further identified similiarities between two trends two decades apart: the trend towards a more natural delivery in the 1980’s, and women asking for a sectio twenty years later. Although these trends are normally regarded as contrary, one of the important similarities is the aim at increased influence of women on their delivery. During the time of research of the paper, the woman’s influence on the choice of vaginal delivery or sectio was limited and constrained by several conditions according to the media. Finally, the paper suggests a possible explanation why fear of birth was such a widely spread phenomenon in Sweden.

Ämnesord

HUMANIORA  -- Historia och arkeologi -- Historia (hsv//swe)

HUMANITIES  -- History and Archaeology -- History (hsv//eng)

Publikations- och innehållstyp

vet (ämneskategori)

ovr (ämneskategori)