Cortes, pontos e contrapontos: embates epistemológicos, humanização do parto e formação em obstetrícia na Bahia

Abstract

This dissertation analyses medical training in obstetrics, focusing on a maternity teaching hospital in Salvador, Bahia. It examines how medical residents construct knowledge, practices, and subjectivities in a daily routine shaped by hierarchies, institutional pressures, and technical-emotional dilemmas. Medical residency, experienced as a rite of passage and a liminal space, found in the chaos of hospital shifts its core learning matrix, under strong tension between technique and emotional involvement, theory and ‘feeling,’ protocol and experience. Based on scientific session observations, field diaries, and autobiographical reflections, the research seeks to understand the disputes within the social field of obstetrics and how the ‘good obstetrician’ is formed – one who balances between structuring dichotomies. The dissertation explores the judicialization of health as a phenomenon that impacts both training and professional practice, potentially reshaping hierarchical structures within the medical-hospital field. The notion of quality of life is taken as an expression of the ambiguities between personal life and professional care. The ethnographic journey is marked by dilemmas and negotiations around the ethics of scientific research, especially in relation to the Research Ethics Committee (CEP) and healthcare professionals as arenas of epistemological dispute. The tension between biomedicine and the human sciences emerges both in bureaucratic-institutional hurdles and in the methodological, relational, and emotional challenges inherent in “studying up” research practices. The thesis offers a critical perspective on disciplinary boundaries and on feminist scientific-political doxa, reflecting on the limits of the enlightened common sense that pervades both scientific and activist discourse. It also outlines two major waves of the childbirth humanization movement in Brazil: i) the aesthetic-individualist ideal of the ‘beautiful birth’; and ii) the collective struggle for reproductive justice and against obstetric violence – including the role of anthropology as a midwife of this movement. By taking herself as part of the field, the researcher brings to light – and assumes – the effects of an anthropology entangled with the object and disputes it seeks to study. Ultimately, this is a dissertation that weaves together science, politics, and life through the ethical and emotional engagement of the researcher in the field.