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出生与社会阶层:泰国北部女性剖宫产和顺产的生活经历

Birth and social class: Northern Thai women's lived experiences of caesarean and vaginal birth.

作者信息

Liamputtong Pranee

机构信息

School of Public Health, La Trobe University, Australia.

出版信息

Sociol Health Illn. 2005 Mar;27(2):243-70. doi: 10.1111/j.1467-9566.2005.00441.x.

Abstract

This paper, based on in-depth interviews with Thai women in Northern Thailand, contributes to a sociological understanding of women's childbirth discourses. The findings indicate that the lived experiences of birth differ between individual women. It clearly shows that social resources such as financial resources and education play a salient role in shaping the embodied experience of birth among women in Northern Thailand. Because of their 'everyday lifestyle', middle class women have more control over the experience of childbirth than that of the rural poor women. Middle class women are able to choose where to give birth, have access to private care and actively seek medical technology as a way to have control over their birth. Their material resources enable their choices. These choices seem to be denied to the rural poor women. But not all rural poor women are passive victims of their material resources. No matter how limited the resources women have, they use them. Hence, there are some poor women who actively seek birthing care that enables them to have more control. But regardless of their social positions (urban middle class or rural poor), obstetric interventions are commonly experienced, and most women perceive caesarean birth in a positive light. Several discourses are employed to explain these findings including women's interpretations of their lived world including risk and the medicalisation of childbirth in Thailand. Taking a feminist standpoint, I argue that differences between women need to be taken into account in providing care to women in childbirth so that sensitive and appropriate birthing care can be achieved.

摘要

本文基于对泰国北部女性的深入访谈,有助于从社会学角度理解女性的分娩话语。研究结果表明,不同女性的分娩实际经历存在差异。这清楚地表明,诸如经济资源和教育等社会资源在塑造泰国北部女性的分娩身体体验方面发挥着显著作用。由于“日常生活方式”的原因,中产阶级女性比农村贫困女性对分娩体验有更多的掌控权。中产阶级女性能够选择分娩地点,获得私人护理,并积极寻求医疗技术以掌控自己的分娩过程。她们的物质资源使她们能够做出这些选择。而农村贫困女性似乎无法做出这些选择。但并非所有农村贫困女性都是物质资源的被动受害者。无论女性拥有的资源多么有限,她们都会加以利用。因此,有些贫困女性会积极寻求能让她们有更多掌控权的分娩护理。但无论她们的社会地位如何(城市中产阶级或农村贫困阶层),产科干预都很常见,而且大多数女性对剖宫产持积极态度。文中运用了几种话语来解释这些发现,包括女性对她们生活世界的解读,如风险以及泰国分娩的医学化。从女性主义立场出发,我认为在为分娩女性提供护理时需要考虑到女性之间的差异,以便实现敏感且恰当的分娩护理。

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