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“每个人都期待完美的婴儿……和完美的分娩……所以你必须保护自己”:在新西兰的助产实践中的防御话语。

'Everybody expects the perfect baby...and perfect labour...and so you have to protect yourself ': discourses of defence in midwifery practice in Aotearoa/New Zealand.

机构信息

The Princess Margaret Hospital, Christchurch, New Zealand.

出版信息

Nurs Inq. 2010 Mar;17(1):82-92. doi: 10.1111/j.1440-1800.2009.00464.x.

DOI:10.1111/j.1440-1800.2009.00464.x
PMID:20137034
Abstract

Increasing fears of litigation among those involved in childbirth impact differently on the 40 midwives I interviewed and observed in the field during the course of my doctoral research. 'Defensive practice' within a culture of 'risk' was a theme that emerged strongly from the interview transcript data from this study, the primary aim of which was to analyse the actions between women and midwives that constitute midwifery partnerships. The context for the analysis was a large ethnographic study undertaken with a variety of midwives working in a main city in Aotearoa/New Zealand in 2003. Complex and contesting forms of knowledge production were analysed drawing on insights from Foucauldian-influenced discourse analysis. My work highlights the ways in which the practices of contemporary midwives in Aotearoa/New Zealand are caught within the intersection of an array of competing discourses. In the data from my study, the midwives talked of their complex negotiations of time and space, and their abilities to balance elements of risk within realms of restraint and responsibility in partnership with women. For the midwives I interviewed, 'keeping ourselves safe' takes place in different locations. Risk is located by some midwives as within the birthing body, and by some, within the spaces of labour ward itself. Both labouring bodies in the midwifery partnership, however, that of the pregnant body of the woman, and that of the working body of the midwife, together occupy spaces of risk/safety where they are amenable to various, and increasingly subtle, forms of governance.

摘要

在我博士研究期间的实地采访和观察中,我采访了 40 名助产士,他们对分娩过程中诉讼风险的日益担忧产生了不同的影响。“防御性实践”在“风险”文化中是一个强烈出现的主题,这是本研究的主要目的,即分析构成助产士伙伴关系的妇女和助产士之间的行动。分析的背景是 2003 年在新西兰奥克兰市与各种助产士一起进行的一项大型民族志研究。从福柯影响的话语分析的见解中分析了复杂和有争议的知识生产形式。我的工作强调了当代新西兰奥克兰的助产士的实践方式如何在一系列相互竞争的话语的交叉点中被捕获。在我的研究数据中,助产士们谈到了他们在时间和空间上的复杂协商,以及他们在与妇女合作的约束和责任领域内平衡风险因素的能力。对我采访的助产士来说,“保护自己的安全”发生在不同的地方。一些助产士将风险定位在分娩体内,而另一些助产士则将风险定位在产房本身。然而,在助产士伙伴关系中的两个劳动体,即妇女怀孕的身体和助产士工作的身体,共同占据了风险/安全的空间,在这些空间中,他们容易受到各种日益微妙的治理形式的影响。

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