Department of Human Health Sciences, Kyoto University, Japan.
School of Clinical Sciences, Auckland University of Technology, New Zealand.
Midwifery. 2022 Sep;112:103407. doi: 10.1016/j.midw.2022.103407. Epub 2022 Jun 16.
The purpose of this article is to understand the meaning of the woman-midwife relationship, with the overall aim to improve maternity care and women's birth experiences in Japan. To better understand the meaning of the woman-midwife relationship, this article presents women's and midwives' experiences of having or not having a voice in maternity care.
Hermeneutic phenomenology, as described by Max van Manen, helped to uncover the meaning of the phenomenon-the woman-midwife relationship-through participants' lived experience. Individual interviews were conducted with 14 women and 10 midwives living in Japan. The interview data were interpreted and thematically analysed to reveal the meaning of the woman-midwife relationship.
'Having a voice' emerged as a central theme underpinning the meaning of the woman-midwife relationship; aspects of which included, 1) being unheard, 2) losing a voice, 3) having a voice, and 4) midwives speaking for women. Although having a voice should be a legitimate right for women in maternity care, some women's voices were unheard or lost in the experience with midwives. Conversely, some women gained a voice, especially when they positively and continuously developed their relationship with their midwife. How the woman and the midwife related to each other clearly affected their experience of having a voice in maternity care.
Having a voice, which portrays dimensions of choice, control, and autonomy, in their own maternity care is vital for women's positive birth experience. The woman-midwife relationship is critical in enabling women to have a voice and midwives to speak for women. Women and midwives need to develop their relationship. Moreover, the maternity care system needs to allow sufficient time and space, for instance, by ensuring midwife continuity of care to develop a positive woman-midwife relationship.
本文旨在理解助产士与产妇的关系的意义，以期整体上改善日本的母婴保健和女性分娩体验。为了更好地理解助产士与产妇的关系的意义，本文呈现了女性在母婴保健中拥有或不拥有话语权的经历。
受麦克斯·范梅南（Max van Manen）描述的阐释现象学的启发，本研究通过参与者的生活经历，揭示了这一现象——助产士与产妇的关系——的意义。本研究对居住在日本的 14 名女性和 10 名助产士进行了个体访谈。对访谈数据进行解释和主题分析，以揭示助产士与产妇关系的意义。
“拥有话语权”是支撑助产士与产妇关系意义的核心主题；其中包括：1）被忽视，2）失去话语权，3）拥有话语权，4）助产士为女性代言。虽然在母婴保健中，女性拥有话语权是一项合法权利，但在与助产士的相处过程中，一些女性的声音被忽视或丢失。相反，一些女性获得了话语权，尤其是当她们与助产士建立积极且持续的关系时。女性和助产士之间的关系如何，显然会影响她们在母婴保健中拥有话语权的体验。
在自己的母婴保健中拥有话语权，代表着选择、控制和自主的维度，对女性积极的分娩体验至关重要。助产士与产妇的关系对于女性拥有话语权和助产士为女性代言至关重要。女性和助产士需要发展她们的关系。此外，母婴保健系统需要提供足够的时间和空间，例如，通过确保助产士的连续照护，以发展积极的助产士与产妇的关系。
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