從性別觀點看醫療化的婦女生產

A Gender Perspective on Medicalized Childbirth

10.6224/JN.62.1.10

郭素珍(Su-Chen Kuo)

生產照護 ； 性別主流化 ； 性別平等 ； childbirth care ； gender mainstreaming ； gender equality

護理雜誌

62卷1期（2015 / 02 / 01）

10 - 15

繁體中文

性別主流化是世界性的議題，聯合國及世界衛生組織強調性別觀點及性別平等概念應融入政府各項重要決策的過程。不同的文化對生產的處理有不同的態度，也影響生產婦女及其伴侶的感受與需求，他們的需求要被瞭解與被滿足。產科醫師們信仰科技與強調生產風險醫療觀點逐漸影響婦女的生產經驗。本篇文章以性別觀點看婦女生產的醫療化、藥物減痛對婦女的壓迫、高剖腹產率責怪婦女、男性參與生產的被忽視，希望可以作為改進性別平等婦女生產照護的參考資料。

Gender mainstreaming is a worldwide issue. The United Nations and the World Health Organization have emphasized the importance of incorporating gender perspectives and gender equity into government policy decisions. Different cultures have different attitudes toward the management of childbirth and these attitudes influence the feelings and needs of women and their partners. These needs must be better understood and satisfied. The widely held technocratic values of obstetricians influence the birthing experience of women significantly. This article uses a gender perspective to describe the medicalization of childbirth, the pharmacological pain-relief oppression of women, the prevalence of blaming women for decisions to conduct Caesarean sections, and the exclusion of men from involvement in the childbirth process. This article may be used as reference to enhance gender equality childbirth care for women.

1. Berghella, V.,Baxter, J. K.,Chauhan, S. P.(2008).Evidence-based labor and delivery management.American Journal of Obstetrics & Gynecology,199(5),445-454.
2. Cahill, H. A.(2001).Male appropriation and medicalization of childbirth: An historical analysis.Journal of Advanced Nursing,33(3),334-342.
3. Chang, S. C.,Chou, M. M.,Lin, K. C.,Lin, L. C.,Lin, Y. L.,Kuo, S. C.(2011).Effects of a pushing intervention on pain, fatigue and birthing experiences among Taiwanese women during the second stage of labour.Midwifery,27(6),825-831.
4. Connell, R. W.(2005).Masculinities.Cambridge, UK:Polity Press.
5. Connell, R. W.(2003).Gender and power.Oxford, UK:Polity Press.
6. Davis-Floyd, R. E.(1994).The technocratic body: American childbirth as cultural expression.Social Science & Medicine,38(8),1125-1140.
7. Deutsch, F. M.(2007).Undoing gender.Gender & Society,21(1),106-127.
8. Fourth World Conference on Women, United Nation Women. (1995, September). Beijing declaration and platform for action. Retrieved from http://www.un.org/womenwatch/daw/beijing/pdf/BDPfA%20E.pdf
9. Gale, J.,Fothergill-Bourbonnais, F.,Chamberlain, M.(2001).Measuring nursing support during childbirth.MCN: The American Journal of Maternal/Child Nursing,26(5),264-271.
10. Hallgren, A.,Kihlgren, M.,Forslin, L.,Norberg, A.(1999).Swedish fathers’ involvement in and experiences of childbirth preparation and childbirth.Midwifery,15(1),6-15.
11. Hammer, R. P.,Burton-Jeangros, C.(2013).Tensions around risks in pregnancy: A typology of women’s experiences of surveillance medicine.Social Science & Medicine,93,55-63.
12. Hodnett, E.(1996).Nursing support of the laboring woman.Journal of Obstetric Gynecologic and Neonatal Nursing,25(3),257-264.
13. Ip, W. Y.(2000).Relationships between partner’s support during labour and maternal outcomes.Journal of Clinical Nursing,9(2),265-272.
14. Johanson, R.,Newburn, M.,Macfariane, A.(2002).Has the medicalisation of childbirth gone too far.BMJ: British Medical Journal,324(7342),892-895.
15. Kuan, C. I.(2014)."Suffering twice": The gender politics of cesarean sections in Taiwan.Medical Anthropology Quarterly,28(3),399-418.
16. Lowe, N. W.(2002).The nature of labor pain.American Journal of Obstetrics and Gynecology,186(5),S16-S24.
17. Maputle, M. S.,Donavon, H.(2013).Woman-centred care in childbirth: A concept analysis (Part 1).Curationis,36(1),49-56.
18. Overgaard, C.,Fenger-Grøn, M.,Sandall, J.(2012).The impact of birthplace on women’s birth experiences and perceptions of care.Social Science & Medicine,74(7),973-981.
19. Premberg, Å.,Carlsson, G.,Hellström, A.-L.,Berg, M.(2011).First-time fathers’ experiences of childbirth-A phenomenological study.Midwifery,27(6),848-853.
20. Premberg, Å.,Taft, C.,Hellström, A.-L.,Berg, M.(2012).Father for the first time - Development and validation of a questionnaire to assess fathers’ experiences of first childbirth (FTFQ).BMC Pregnancy and Childbirth,12(1),35.
21. Simkin, P.,Bolding, A.(2004).Update on nonpharmacologic approaches to relieve labor pain and prevent suffering.Journal of Midwifery & Women’s Health,49(6),489-504.
22. Tracy, S. K.,Sullivan, E.,Wang, Y. A.,Black, D.,Tracy, M.(2007).Birth outcomes associated with interventions in labour amongst low risk women: A population-based study.Women and Birth,20(2),41-48.
23. Vivilaki, V.,Antoniou, E.(2009).Pain relief and retaining control during childbirth. A sacrifice of the feminine identity?.Health Science Journal,3(1),3-9.
24. Williams, S. C.,Mackey, M. C.(1999).Women’s experiences of preterm labor: A feminist critique.Health Care for Women International,20(1),29-48.
25. Wu, C. L.(2007).Explaining the high cesarean-section rate in Taiwan: Surveying women, individualizing risk, and orientalizing Taiwan.Society for Social Studies of Science Annual Meeting,Montreal, Canada:
26. 官晨怡, C. I.(2013)。生產中的現代性：科技信仰與科技侷限的競技場。臺灣人類學刊，11(1)，65-91。

1. 劉介宇,陳治平,梁慧敏,高美玲(2019)。入院待產時機教育課程於孕婦焦慮、不確定感、生產控制感及待產結果之成效。護理雜誌，66(2)，36-47。
2. 沈滿華,田淑惠(2019)。從醫療弱勢族群的照護看平等權的落實－以同性戀孕產婦為例。護理雜誌，66(5)，65-71。
3. 施麗雯(2019)。孕產照護邏輯：台灣女性的新生育選擇與共同修補。女學學誌：婦女與性別研究，44，1-46。
4. 施麗雯(2021)。妳如何能不憂鬱？從產前到產後心理健康照護。台灣公共衛生雜誌，40(6)，595-599。