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  • 學位論文

影像的故事:懷孕婦女經歷婦產科超音波的經驗與性別意涵

The stories of images:the experience of pregnant women with ultrasound and its gender significance

指導教授 : 王秀雲

摘要


超音波在台灣今日的產前檢查中扮演很重要的角色,而目前國內文獻多著眼於宣揚超音波的功能性,很少從婦女的經驗出發,來看待超音波與婦女懷孕的關係。因此本研究以質性研究的方法,由女性對懷孕及胎兒影像的理解著手,以描繪懷孕婦女所經歷的醫療措施,並探究超音波檢查及胎兒影像對婦女懷孕經驗的意義與關係;也探討了超音波技術的運用及其視覺化效果,在婦產科醫用互動及生產醫療化過程裡所扮演的角色,同時它又是如何影響懷孕婦女的生命經驗與社會關係。 本研究以立意取樣的方式,實地在高雄某醫學中心進行參與觀察以及深度訪談為資料收集法,總共訪談了第一胎懷孕婦女九位與婦產科醫師三位。研究結果發現,在超音波檢查過程中,孕婦與醫師之間存有知識與權力的不平等關係;加上對胎兒健康與優生保健的關注,將胎兒標準醫療化的結果,使胎兒影像成為重要的參考價值,而孕婦也須依賴醫師解讀影像,種種因素 間接地使婦女的懷孕經驗受到影響。孕婦因此須自我管理,使其行為符合社會性的母職。再者,孕婦可能也因影像而對自己身體產生疏離感;或是將超音波科技物納入為自己身體感覺的一部分,因為孕婦對影像也有一套詮釋的腳本,認為超音波影像帶給她們的,是懷孕的真實感與愉悅,並從中獲得母職實踐的成就感與意義。 基於上述研究發現,醫師的再教育實有其必要,其內涵應重視醫用關係的溝通與權力性質,並盡量在超音波檢查過程不告知孕婦胎兒性別;另外也要教育懷孕婦女關於超音波的相關訊息,並鼓勵其與自我身體對話。最後,基於本研究的諸多限制,建議未來相關研究可以針對非自願懷孕、人工流產或是懷孕過程中發現胎兒異常的婦女。

關鍵字

超音波 胎兒影像 懷孕婦女 性別

並列摘要


Ultrasound scan is routinely and frequently used in prenatal care in Taiwan. The images of the fetus are seen as the major evidence of the fetus’s health status, and the focus on fetal health is a result of growing eugenics tendency in reproductive medicine and medicalization of the fetus. Much has been done in examining the utilities of ultrasound scan, but without taking the pregnant woman’s experience into account. This thesis, starting with women’s understandings of ultrasound scan images of pregnancy and the fetus, uses qualitative research to explore what the ultrasound scan and its images mean to pregnant women and how technology has become a integral part of women’s experiences with pregnancy. In addition, this thesis examines the doctor-patient relationship and the role of ultrasound scan in the process of medicalization. To understand the interactions between the doctor and the women during the ultrasound scan, an observation is carried out at an outpatient clinic of a large teaching hospital in Kaohsiung, where a male obstetrician is in charge. In addition, I conducted interviews with nine women in their first pregnancy and three doctors. The author finds that there is an asymmetry of knowledge and power between the doctor and pregnant women with regard to ultrasound exams. Women do not necessarily have the skills in reading the scan images, and they are forced to rely on their physicians’ interpretations of the images. All these factors are important in shaping women’s experience of pregnancy. In the context of risk culture, women often have to behave themselves in order to fit in with socialized motherhood. Moreover, while some women may feel alienated from their bodies when they look at the ultrasound images, for others technology can be an extension of their body, because they have different scripts of interpretation of ultrasound scan. In the latter case, the scan images are an integral part of the reality and delight of pregnancy, and women gain a sense of satisfaction and can construct the meaning of practicing motherhood accordingly. In conclusion, I recommend educating physicians to enhance their communication skills and to improve doctor-patient relationship. Using ultrasound scan to identify the sex of the fetus should not be allowed. Furthermore, it is necessary to educate pregnant women about the capabilities and limitations of ultrasound scans and encourage them to create alternative views of their bodies. Finally, as this current study is limited in several ways, I suggest that further studies may include women with unwelcome pregnancy or problematic pregnancy.

並列關鍵字

ultrasound fetus image pregnant women gender

參考文獻


一、中文部份
中央健保局(1995)〈孕婦可享那些產檢權益?〉,《家庭月刊》,84年10月。
中央健保局(2007)《懷孕及生產照護過程(產前篇)》http://www.nhinb.gov.tw/chinese/13_baby/03_detail.asp?mainid=1&id=1,
讀取日期:95年10月。
朱大維等人(1995)〈產科超音波〉,《國防醫學》,21(6): 456-462。

被引用紀錄


關惠鍾(2011)。懷孕狀態與兩階段產前遺傳檢查的個人知識、知識需求、不確定感及接受度之關係〔碩士論文,國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342%2fNTU.2011.00964
高玉馨(2010)。從使用者角度看醫用超音波及其影像在台灣婦產科的發展〔碩士論文,國立清華大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0016-1901201111415466

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