McLean Kristen E
International Studies Program, College of Charleston, 9 Glebe Street, Charleston, SC, 29424, USA.
Soc Sci Med. 2020 Nov;265:113479. doi: 10.1016/j.socscimed.2020.113479. Epub 2020 Oct 29.
In recent decades, global health researchers and policy makers have advocated for men's increased involvement in pregnancy and childbirth with the goal of improving maternal health outcomes. By "involvement," these actors generally refer to narrow-largely Western-definitions of participation: accompanying women to antenatal and postpartum care visits, engaging in childbirth education, or being present during delivery. However, such approaches often fail to account for the culturally valid and gendered ways in which men already are involved in supporting women's reproductive health. This study is based on participant observation, semi-structured interviews, and life histories conducted among 106 fathers in eastern Sierra Leone over the course of 2013-2016. Findings demonstrate that in Sierra Leone, where pregnancy and childbirth are considered to belong to the domain of women, men's primary role is to supply the material resources for a safe and healthy birth: a nutritious diet, transportation to healthcare facilities, medicines and supplies in the case of emergency, and the items to wash and dress the baby. While evidence suggests that gender norms are shifting to include other forms of intimate and emotional involvement, it is important to recognize existing forms of material support as valuable and essential forms of care. By restricting male involvement to biomedical notions of care, global health programs and policies risk discounting other types of socially meaningful support. Rather than disparaging young, African men for falling short of what Western organizations and researchers perceive to be "correct" behaviors, this paper attempts to highlight men's own understandings of involvement, so as to provide a more complete picture of the gendered nature of reproductive health in this context.
近几十年来，全球卫生研究人员和政策制定者一直倡导男性更多地参与怀孕和分娩过程，目标是改善孕产妇健康结果。这些行动者所说的“参与”，通常指的是狭义的——主要是西方的——参与定义：陪女性进行产前和产后护理访视、参加分娩教育或在分娩时在场。然而，这种方式往往没有考虑到男性已经以符合文化且具有性别特点的方式参与支持女性生殖健康。本研究基于2013年至2016年期间在塞拉利昂东部对106位父亲进行的参与观察、半结构化访谈和生活史研究。研究结果表明，在塞拉利昂，怀孕和分娩被视为女性的领域，男性的主要作用是提供安全健康分娩所需的物质资源：营养饮食、前往医疗机构的交通、紧急情况下的药品和用品，以及清洗和包裹婴儿的物品。虽然有证据表明性别规范正在转变，以纳入其他形式的亲密和情感参与，但重要的是要认识到现有的物质支持形式是有价值且至关重要的护理形式。通过将男性参与局限于生物医学护理观念，全球卫生项目和政策有可能忽视其他类型的具有社会意义的支持。本文并非贬低年轻的非洲男性没有达到西方组织和研究人员所认为的“正确”行为，而是试图突出男性自身对参与的理解，以便更全面地呈现这种背景下生殖健康的性别本质。
