妊産褥婦の主体的な取り組み : 助産院での縦断的面接を通して  [in Japanese] A qualitative study on the subjective coping with pregnancy and delivery by women hoping to delivery at one maternity hospital  [in Japanese]

本研究では, 妊婦が主体的に妊娠, 出産に取り組むために必要な助産師の援助である, フリースタイル出産, バースプランなどが実施されている助産院での出産希望者を対象とし, 主体的な妊娠, 出産の様態の明確化を試みた。4名の対象に, 妊娠から産褥までを通して縦断的に半構成的面接を行い, データ分析はGrounded Theory Approachに基づきコード化, カテゴリー化した。結果, 「健康への自信に基づいた自己管理」をコアとし, 「自分の力」をらせん的連続性で発展させていた。また, 自身に問いかけ, 対応を策し, 自身の気持ちと会話し折り合いをつけ, 自分自身とのコミュニケーションを行っていた。主体的な取り組みとは, 妊娠を自分のものと自覚し, 自身の問題を発見できる力をもち, それに対して自分とのコミュニケーションを通して解釈し, 自身の行為を決定し, 実践, 評価していく過程である。したがってこれらを促すためには, 助産師自身が女性の力を信じ, 女性自身がそれに気づく機会をつくり, 女性の自分とのコミュニケーションをサポートし, 継続して共に過ごす時空をつくるようなかかわりが必要であるとの示唆を得た。

This study is an attempt to make clear the conditions of subjective coping with pregnancy and delivery by women hoping to deliver at T maternity hospital. This maternity hospital practices maternity care for pregnant women helping them to cope with pregnancy and delivery subjectivity by making them aware of modalities such as free style delivery and birth plans. Semi-structured interviews were conducted with 4 women hoping to deliver at T maternity hospital through out pregnancy to after delivery. From the qualitative analyses of the interview data based on Grounded Theory Approach, women developed their "Personal abilities" spiraling continuously centering around on self-care based on confidence in their own health. And women asked themselves and took measures and made compromises talking and communicating with themselves. Women's subjective coping during the perinatal period requires being conscious of their pregnancy and its problems and the ability to find and interpret her health problems in self-communication and the ability to make decisions and practice and evaluate self action. In order to promote women's subiective coping in the perinatal period, it is necessary for midwives to believe in women's innate ability and awaken their awareness and support their self-communication and establish a continuous space-time with women.