This research explored the reasonsfor women’s preferences for cesarean sectionbirths in Pelotas, Brazil. It is argued thatwomen strategize and appropriate both medicalknowledge and the technology of cesareansections as a creative form of responding tolarger public debates (and the practices thatproduced them) on the need for and causes of(de)medicalization. Questioning the reasons whysome women engage more actively in this processthan others elucidates the ways local forms ofpower engage gender, economic and medicalideologies. The current debate on why somewomen prefer c-section deliveries, or indeed ifthey really do at all, has diverted attentionfrom the utility of the technology itself. Thispaper argues that for some women, the effort tomedicalize the birth process represents apractical solution to problems found within themedical system itself. I end by exploring thesocio-biological conditions that have produceda need for the technology.