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      Medical borderlands: engineering the body with plastic surgery and hormonal therapies in Brazil

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          Abstract

          This paper explores medical borderlands where health and enhancement practices are entangled. It draws on fieldwork carried out in the context of two distinct research projects in Brazil on plastic surgery and sex hormone therapies. These two therapies have significant clinical overlap. Both are made available in private and public healthcare in ways that reveal the class dynamics underlying Brazilian medicine. They also have an important experimental dimension rooted in Brazil's regulatory context and societal expectations placed on medicine as a means for managing women's reproductive and sexual health. Off-label and experimental medical use of these treatments is linked to experimental social use: how women adopt them to respond to the pressures, anxieties and aspirations of work and intimate life. The paper argues that these experimental techniques are becoming morally authorized as routine management of women's health, integrated into mainstream Ob-Gyn healthcare, and subtly blurred with practices of cuidar-se (self-care) seen in Brazil as essential for modern femininity.

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          Most cited references48

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          The Politics of Life Itself. Biomedicine, Power and Subjectivity in the Twenty-First Century.

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            Deconstructing the placebo effect and finding the meaning response.

            We provide a new perspective with which to understand what for a half century has been known as the "placebo effect." We argue that, as currently used, the concept includes much that has nothing to do with placebos, confusing the most interesting and important aspects of the phenomenon. We propose a new way to understand those aspects of medical care, plus a broad range of additional human experiences, by focusing on the idea of "meaning," to which people, when they are sick, often respond. We review several of the many areas in medicine in which meaning affects illness or healing and introduce the idea of the "meaning response." We suggest that use of this formulation, rather than the fixation on inert placebos, will probably lead to far greater insight into how treatment works and perhaps to real improvements in human well-being.
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              Parto cesáreo: quem o deseja? Em quais circunstâncias?

              O Brasil apresenta altos índices de cesáreas. Este estudo investigou a existência de uma "cultura de cesárea", ou preferência por este tipo de parto, através de uma amostra de 909 puérperas (454 vaginais e 455 cesáreos) em duas maternidades do Município do Rio de Janeiro, onde entrevistas e revisão de prontuários foram realizados entre setembro de 1998 e março de 1999. Perguntou-se às mulheres se queriam que seu parto fosse cesáreo e a maioria absoluta (75,5%) respondeu "não", as razões principais sendo: "recuperação mais difícil e lenta no parto cesáreo" (39,2%) e "dor e sofrimento maior depois da cesárea" (26,8%). Apenas 17% das mulheres solicitaram cesárea e, destas, cerca de 75% o fizeram durante o trabalho de parto/parto. Análise mostrou que quanto maior o intervalo de tempo entre a admissão no hospital e o parto, mais freqüente é a solicitação. A maioria das mulheres, nas maternidades estudadas, não quer e não pede cesárea; ou seja, não existe uma ‘cultura’ feminina que valorize a cesárea como preferência. Além do desejo da laqueadura, as circunstâncias concretas da assistência no pré-parto/parto parecem influenciar no pedido da mulher.
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                Author and article information

                Journal
                Anthropol Med
                Anthropol Med
                CANM
                canm20
                Anthropology & Medicine
                Routledge
                1364-8470
                1469-2910
                4 May 2014
                30 August 2014
                : 21
                : 2 , Mediating Medical Technologies: Flows, Frictions and New Socialities
                : 202-216
                Affiliations
                [ a ]University of Edinburgh , Edinburgh, UK
                [ b ]Ecole normale supérieure de Lyon, Laboratoire Triangle & INSERM , 15 Parvis René Descartes, Lyon, France
                Author notes
                [* ]Corresponding author. Email: alex.edmonds@ 123456gmail.com
                Article
                918933
                10.1080/13648470.2014.918933
                4200605
                25175295
                64d28a0e-f016-4603-bc3b-94c3a5ece3fd
                © 2014 The Author(s). Published by Taylor & Francis.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0/, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The moral rights of the named author(s) have been asserted.

                History
                : 10 April 2014
                : 24 April 2014
                Page count
                Figures: 0, Tables: 0, References: 45, Pages: 15
                Categories
                Original Papers

                Anthropology
                plastic surgery,hormonal therapies,brazil,gender and sexuality,reproductive health
                Anthropology
                plastic surgery, hormonal therapies, brazil, gender and sexuality, reproductive health

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