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莎拉的出生。分娩的医学化在不同环境中可能如何形成:来自沙特阿拉伯吉达常规干预研究的案例

Sarah's birth. How the medicalisation of childbirth may be shaped in different settings: Vignette from a study of routine intervention in Jeddah, Saudi Arabia.

作者信息

Scamell Mandie, Altaweli Roa, McCourt Christine

机构信息

Centre for Maternal and Child Health, School of Health Sciences, City, University of London, Northampton Square, London EC1V 0HB, England, United Kingdom.

Centre for Maternal and Child Health, School of Health Sciences, City, University of London, Northampton Square, London EC1V 0HB, England, United Kingdom.

出版信息

Women Birth. 2017 Feb;30(1):e39-e45. doi: 10.1016/j.wombi.2016.08.002. Epub 2016 Sep 29.

Abstract

BACKGROUND

The expansion of the medicalisation of childbirth has been described in the literature as being a global phenomenon. The vignette described in this paper, selected from an ethnographic study of routine intervention in Saudi Arabian hospitals illustrates how the worldwide spread of the bio-medical model does not take place within a cultural vacuum.

AIM

To illuminate the ways in which the medicalisation of birth may be understood and practised in different cultural settings, through a vignette of a specific birth, drawn as a typical case from an ethnographic study that investigated clinical decision-making in the second stage of labour in Saudi Arabia.

METHODS

Ethnographic data collection methods, including participant observation and interviews. The data presented in this paper are drawn from ethnographic field notes collected during field work in Saudi Arabia, and informed by analysis of a wider set of field notes and interviews with professionals working in this context.

FINDINGS

While the medicalisation of care is a universal phenomenon, the ways in which the care of women is managed using routine medical intervention are framed by the local cultural context in which these practices take place.

DISCUSSION

The ethnographic data presented in this paper shows the medicalisation of birth thesis to be incomplete. The evidence presented in this paper illustrates how local belief systems are not so much subsumed by the expansion of the bio-medical model of childbirth, rather they may actively facilitate a process of localised reinterpretation of such universalised and standardised practices. In this case, aspects of the social and cultural context of Jeddah operates to intensify the biomedical model at the expense of respectful maternity care.

CONCLUSION

In this article, field note data on the birth of one Saudi Arabian woman is used as an illustration of how the medicalisation of childbirth has been appropriated and reinterpreted in Jeddah, Saudi Arabia.

摘要

背景

分娩医学化的扩张在文献中被描述为一种全球现象。本文所描述的案例,选自对沙特阿拉伯医院常规干预的人种志研究,说明了生物医学模式在全球的传播并非发生在文化真空中。

目的

通过一个特定分娩案例的描述,阐明在不同文化背景下如何理解和实践分娩医学化。该案例是从一项人种志研究中选取的典型案例,该研究调查了沙特阿拉伯分娩第二阶段的临床决策。

方法

人种志数据收集方法,包括参与观察和访谈。本文呈现的数据来自在沙特阿拉伯实地考察期间收集的人种志田野笔记,并参考了对更广泛的田野笔记的分析以及对在此背景下工作的专业人员的访谈。

研究结果

虽然护理医学化是一种普遍现象,但使用常规医疗干预来管理女性护理的方式是由这些实践发生的当地文化背景所构建的。

讨论

本文呈现的人种志数据表明分娩医学化理论并不完整。本文提供的证据说明了当地信仰体系并非在很大程度上被分娩生物医学模式的扩张所包容,相反,它们可能积极促进对这种普遍化和标准化实践的本地化重新诠释过程。在这种情况下,吉达社会文化背景的某些方面加剧了生物医学模式,却牺牲了尊重产妇护理。

结论

在本文中,一位沙特阿拉伯女性分娩的田野笔记数据被用作一个例子,来说明分娩医学化在沙特阿拉伯吉达是如何被采用和重新诠释的。

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