School of Nursing and Midwifery, Oxford Brookes University/University of Oxford, Oxford, UK.
Department of Nursing, Midwifery and Child Health, Middlesex University, Middlesex, UK.
Sociol Health Illn. 2022 Feb;44(2):308-327. doi: 10.1111/1467-9566.13429. Epub 2022 Jan 25.
We present findings from a longitudinal ethnographic study of infertile couples seeking treatment following initial GP referral to specialist fertility services. Repeated observations and interviews were undertaken with the same 14 heterosexual participants over an 18-month period. Heterosexual, non-donor couples comprise the majority of fertility clinic patients; however, research interest in this group has dwindled over time as IVF cycles have increased. In the United Kingdom, IVF is presented as a logical response to involuntary childlessness, and as an entirely predictable, and linear, course of action. The market is well-developed and often patients' first experience of privatised health care in the NHS. Our couples were challenged by this, and while they felt expected to move on to IVF, some wished to explore other options. While IVF is ubiquitous, the discomfort and challenge around fertility treatments remain; experiences are prolonged and characterised by recursive narratives and expressions of disequilibrium, which are rarely acknowledged and reflected in ongoing clinic-patient interactions. Our findings develop understanding of the process of 'mazing' (Image - The Journal of Nursing Scholarship, 1989, 21, 220), the pursuit of parenthood, by showing that the routine and normative status of IVF, at least in the current health care context, is at odds with the lived experiences of individuals.
我们呈现了一项纵向人种学研究的结果,该研究对象是在向专科生育服务机构初次转诊后寻求治疗的不孕夫妇。在 18 个月的时间里,对 14 对相同的异性恋参与者进行了反复的观察和访谈。异性恋、非捐赠夫妇构成了生育诊所患者的大多数;然而,随着 IVF 周期的增加,研究对这一群体的兴趣逐渐减少。在英国,IVF 被视为对非自愿不孕不育的合理反应,也是一种完全可预测和线性的行动过程。市场已经非常发达,而且通常是患者在国民保健制度中首次体验私人医疗保健的地方。我们的夫妇对此感到不满,尽管他们觉得应该继续进行 IVF,但有些夫妇希望探索其他选择。虽然 IVF 无处不在,但生育治疗的不适和挑战仍然存在;治疗过程延长,并以递归叙述和失衡表达为特征,这些在持续的医患互动中很少得到承认和反映。我们的研究结果通过展示生育治疗的“漫游”(Image - The Journal of Nursing Scholarship,1989,21,220)过程,即追求成为父母的过程,加深了对该过程的理解,至少在当前的医疗保健背景下,IVF 的常规和规范地位与个人的生活经历不一致。