title: Users' and providers' perspectives on technological procedures for 'normal' childbirth in a public maternity hospital in Salvador, Brazil.
abstract: OBJECTIVE
  To reveal the effect of cultural practices on the way in which normal birth is conducted in a public hospital in Brazil.
  
  
  METHODS
  This article about a public maternity hospital in Salvador, Brazil, compares the points of view of providers and users on four technological normal childbirth procedures: trichotomy, episiotomy, oxytocin infusion, and epidural analgesia. Fieldwork carried out from 2002 to 2003 combined qualitative and quantitative methods.
  
  
  RESULTS
  Institutional practices make childbirth unnecessarily difficult for women. Nonetheless, most women accept the conditions because the medical procedures make sense according to their cultural understandings. Service providers support the use of such procedures, although doctors are aware that they contradict recommendations found in scientific medical literature. This article argues that from the perspective of both providers and users, the technological procedures are infused with a culturally specific set of meanings and values.
  
  
  CONCLUSIONS
  Policymakers must address the cultural understandings of both users and health care professionals in order to improve maternal healthcare in public hospitals in Brazil.
authors.affiliation: Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil. cecilia.mccallum@uol.com.br
authors.forename: Cecilia
authors.initials: C
authors.lastname: McCallum
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: dos Reis
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil; D003466:Cultural Characteristics; D005260:Female; D006282:Health Personnel; D006771:Hospitals, Maternity; D006779:Hospitals, Public; D006801:Humans; D009321:Natural Childbirth / Q000379:methods*; D011247:Pregnancy