Caesarean sections (C-sections) have become a substitute for vaginal birth in a number of developing and emerging economies. Often in these contexts, the promotion of caesarean delivery as a safe or even zero-risk and zero-pain alternative to vaginal birth continues to serve as a powerful discursive tool in governing childbirth, despite growing international evidence on the iatrogenic effects of C-sections. These caesarean ‘epidemics’ are often explained in terms of obstetricians’ individual preferences for C-sections. Drawing on ethnographic research conducted in one private and one public hospital in western Turkey, I argue that there are a wide range of factors influencing obstetricians’ risk conceptualisations, discourses and practices. I also contend that the medical justifications for C-sections and their public popularity can best be understood by looking at the ways in which both caesarean and vaginal births are organised. In the settings examined, the processes around caesarean and vaginal births were blurred to such an extent that vaginal delivery was, in its technicised and closely monitored nature, transformed into what I propose to call ‘vaginarean’ birth. Recent state regulations in Turkey aiming to prevent ‘caesarean abuse’ had only had limited effects on obstetricians’ practices. The notion of risk continued to operate as a major driving force in that an institutional risk colonisation came to compete with medical framings of risk, while deficiencies in the national obstetric care system were made invisible. I conclude that regulations aimed at eradicating a caesarean epidemic, such as those implemented in Turkey since 2012, are unlikely to be effective unless they also aim to combat the vaginarean epidemic.

在许多发展中和新兴经济体中，剖腹产已成为阴道分娩的替代品。在这些情况下，尽管有越来越多的国际证据表明剖腹产的医学证据表明，促进剖腹产作为阴道分娩的一种安全，甚至零风险和零疼痛的替代方法仍继续是控制分娩的有力推论工具。 。这些剖腹产“流行病”通常是根据产科医生对剖腹产的个人偏好来解释的。利用土耳其西部一所私立和一所公立医院进行的人种学研究，我认为影响妇产科医生风险概念，论述和实践的因素广泛。我还认为剖腹产和阴道分娩的组织方式可以最好地理解剖腹产的医学依据及其在公众中的受欢迎程度。在所检查的环境中，剖腹产和阴道分娩的过程变得模糊不清，以至于阴道分娩在技术上和严密监控下已转变为我建议的“阴道分娩”。土耳其最近的旨在防止“剖腹产”的国家法规对产科医生的做法影响有限。风险的概念继续作为主要驱动力，因为机构风险殖民化开始与风险的医学框架竞争，而国家产科护理系统的缺陷却变得不可见。