Interest in Brazilian Culture Leads to My Honors Thesis on Family Planning

by Daniella Gonzalez, 19C
Neuroscience and Behavioral Biology, and Spanish and Portuguese
Fox Center Undergraduate Humanities Honors Fellow

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I enrolled in my first Portuguese class during my first semester attending Emory given my interest in Brazilian culture. Little did I know at the time that Brazil and the Portuguese language would become incredibly important to me throughout the next four years. During my junior year, I was given the opportunity to conduct research in Brazil with Dr. Jeffrey Lesser and his research team. Upon my arrival, Dr. Lesser and fellow undergraduate researchers introduced me to the healthcare providers of a public primary healthcare clinic, called the UBS, located in the Bom Retiro neighborhood of São Paulo, Brazil. This UBS is where I conducted my five weeks of research. I knew I wanted to focus on women’s health, but I did not have a specific research question in mind. I then began joining the physicians and nurses during their medical appointments with pregnant women to better understand gestational care in the clinic. This is when I noticed the medical files of these women specified whether their pregnancies were planned or unplanned. One of the physicians explained to me that the municipal government of São Paulo asked for this information in daily activity logs. However, I found it difficult to believe patients and their providers all shared the same conceptualizations of planned and unplanned pregnancies given the diversity of the Bom Retiro neighborhood. At this point, I knew understanding how women and their healthcare professionals thought about family planning was an important matter that I wanted to research.

I conducted my research as a two-part project using demographic data and oral histories from patients and their healthcare providers. Women shared their stories with me during medical appointments and elaborated on the factors that influence their own relationships with their pregnancies. Healthcare providers also shared their conceptualizations of family planning and described differences they perceived in prenatal care for women with planned pregnancies and women with unplanned pregnancies. Additionally, I gathered information from the prenatal medical files provided to me, including the age, marital status, nationality, monthly income and appointment attendance of the registered pregnant patients. I used this data to statistically test whether women with unplanned and planned pregnancies differed in any one of the points measured. I pulled these sources together and demonstrate in my thesis that providers and patients do indeed think about family planning in different ways. These varying conceptualizations produce a gap between providers and patients that does not allow for conversations that challenge stereotypes in current discourse. Two stereotypes that frequently came up in conversation were 1) immigrant women have more unplanned pregnancies and do not assume responsibility and 2) women that have unplanned pregnancies are more likely to have inadequate prenatal care during their pregnancies. My statistical data made evident that these claims were false, and providers and patients alike maintain negative stereotypes against unplanned pregnancies and immigrant women. Without conversations between patients and their healthcare professionals, these stereotypes fail to be addressed and challenged. This results in women not wanting to share their experiences with family planning or to describe their pregnancies as unplanned to begin with. Additionally, the categories of “planned” and “unplanned” do not provide to the municipal government adequate about the realities of the women of Bom Retiro. Thus, I argue documents created by the State should include questions that encourage conversations between patients and providers rather than attempting to dichotomize such complex experiences.

I am incredibly grateful for my time as a Fox Undergraduate Humanities Honors Fellow. The space and resources provided to me have been incredibly helpful throughout the challenging process of analyzing my data and writing my thesis. I have also been introduced to fellow undergraduate researchers that are supportive and eager to learn more about my work and future directions. The resources and friendships created will always be appreciated as I think about my undergraduate academic career.

Daniella Gonzalez is a senior majoring in Neuroscience and Behavioral Biology, and Spanish and Portuguese. She is writing an honors thesis on family planning for both patients and healthcare providers within the public health care system of Brazil (SUS). She conducted research during the summer of 2018 in a clinic in Bom Retiro, São Paulo. Daniella’s thesis delves into prenatal and postnatal care in the UBS of Bom Retiro, a primary healthcare clinic. Her work also highlights the varying definitions of family planning for the various participants within gestational care, including patients, physicians, nurses, and community agents.  

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