Analysis of Process of Forming the "Ability to Become a Parent" : What Relation is Established Between a Pregnant Woman and a Midwife in the Initial Checkup? (Notes)

Abstract

Background Today, the problem concerning the child care, like a Child Abuse, is a social task. As a result, the research to solve these problems is increasing, too. However, most of those focus on to the support after the child is born, the study from the pregnancy period is a little. Especially, there is no thesis that focuses on to the relation to others in order to nurture the "ability to become a parent" , at the pregnancy period. Objective The purpose of this study was to verify how midwife is involved with pregnant women, as well as learn about the relationship established between pregnant women and midwife. Method 1. A total of 26 women were observed and recorded with VTR during their clinical checkups at the maternity home in N city. 2. Three pregnant women who felt satisfied with in their first checkup were selected. 3. All contents of verbal and non-verbal communications between the pregnant women and a midwife were described a verbatim form and analyzed qualitatively. Results The three pregnant women all had worries, anxieties and troubles. They were expressed in the course of conversation with the midwife. Pregnant women were never rushed into the examination room, but moved at their own pace, and were given ample time to think and remember as they talked. They were able to allow the midwife to understand not only the physical changes involved in their pregnancy, but also their concerns about life in general. On the other hand, the midwife asks pregnant women clear, direct questions regarding their pregnancy and health. However, regarding anxieties and doubts, the midwife asked discreetly, and never forced the women to speak of their feelings. She kept her eyes on the women, and nodded with empathy in perfect timing. Conclusion The relationship established between midwife and pregnant women was one of trust (dependency).

背景 今日、児童虐待に代表されるような育児問題は大きな社会的問題になってきている。そこで、それらの問題を解決するための方法も取り組まれてきている。しかしながら、これらの多くは子どもが産まれてからの対応に焦点をあてたものであり、妊娠期からの支援は少ない。特に「親となる力」を育むために妊娠期での他者との関係性に焦点をあてたものは見あたらない。目的 本稿では親となる形成過程を明らかにする第一段階として、看護識者(助産師)が妊婦にどのように関わり、妊婦と助産師がどのような関係にあるのかを明らかにする。方法 1. N市の助産院に来院した妊婦26人の健診場面を参加観察した。2.初めての健診で、妊婦自らが満足したと語った3人を分析対象とした。3.同意が得られた妊婦と助産師の会話や表情、しぐさといったノンバーバルコミュニケーションの全内容を記述し分析を行った。結果 3人の妊婦はそれぞれ心配事、不安や悩みを持っていた。これらは助産師との対話の中で語られた。診察室では、妊婦たちはあせらされることなく自分のペースで行動し、ゆったりと思い出しながら話すことが出来ていた。彼女たちは助産師に妊娠に伴う身体的な変化を把握してもらうだけでなく、生活全般の悩みを助産師に語っていた。一方、助産師は妊娠や健康に関する項目を明確に質問している。しかし妊婦の不安、迷いの訴えに対しては、さりげなく尋ね、妊婦たちの思いを無理に聞き出すことはしていない。妊婦たちを見つめながら、気持ちのこもったタイミングのよい相づちを打つだけであった。結論 初回の妊婦健診において助産師と妊婦たちの関係は、信頼(甘えることができる)関係を形成していた。