探討COVID-19疫情期間中國城鎮女性意外懷孕與生產經驗

Exploring the experience of unintended pregnancy and childbirth among township Chinese women during the COVID-19 pandemic

肖芷怡(Zhi-yi Xiao)

指導教授 ： 官晨怡

國立臺灣大學/公共衛生學院/健康行為與社區科學研究所/碩士(2022年)

https://doi.org/10.6342/NTU202204173

摘要

2019年底COVID-19疫情在湖北武漢爆發後，隨即擴散至全中國以及世界。為控制病毒傳播，許多城市與地區採取封城措施，醫療資源和社會注意力也都向這一新型的傳染病傾斜，許多基礎的醫療服務無法照常提供。在這期間意外懷孕的女性，面臨著在疫情這一特殊背景下醫療資源的獲取和生育決策制定的複雜情境，包括出於對傳染病感染的恐懼，不敢前往醫院就醫；想要通過手術/藥物流產，卻因防疫政策的層層阻攔無法成行；減少現實社交接觸後，懷孕女性獲取醫療訊息的有效性和真實性都受到了挑戰。
為瞭解疫情對女性在性與生殖健康相關醫療資源的影響，本研究通過立意抽樣和滾雪球抽樣的方式，招募在湖北疫情早期十一位有意外懷孕經驗的女性，兩位非意外懷孕女性與四位疫情期間在婦產科工作的醫護人員，進行半結構式的線上深度訪談。此外，本研究也爬梳中國社交網路平台「微博」與「小紅書」中疫情期間意外懷孕女性的發帖，結合不同處境下女性的意外懷孕經驗，呈現疫情期間女性在生產議題面臨的複雜情境。
研究發現，疫情期間懷孕女性的產檢與就醫都受到了不同程度的影響，醫療機構與懷孕女性之間的資訊落差也因為封城而加劇。通過女性主義視角檢視疫情期間意外懷孕女性經驗，分析家庭、醫療場域、疫情防控和國家政策對於女性生殖健康的規訓，以及其中女性生育自主權上的體現、讓渡與斡旋。本研究呈現疫情期間生殖健康服務的提供方式與醫療訊息的傳遞場景，以利改進資訊傳播方式與醫療服務安排，提升懷孕女性在疫情期間獲取醫療服務的質量與可近性。

關鍵字

COVID-19 ； 意外懷孕 ； 生殖健康 ； 質性研究 ； 中國湖北

並列摘要

After the outbreak of COVID-19 in Wuhan, Hubei Province at the end of 2019, it spread to the whole of China and the world. In order to control the spread of the epidemic, many cities and regions have adopted lockdown measures. Medical resources and social attention are also tilted towards this new type of infectious disease, and many basic medical services cannot be provided as usual. Women who become pregnant unexpectedly during this period are faced with the complicated situation of obtaining medical resources and making reproductive decisions under the special background of the epidemic. Out of fear of infectious disease infection, some participants are afraid to go to the hospital for medical treatment; others want to undergo surgery/ medical abortion, but cannot be done due to the prevention of epidemic prevention policies; the stigma of unmarried unintended pregnancy and the joy of married unintended pregnancy were also mentioned.
In order to understand women's cognition and experience of unintended pregnancy and the impact of the epidemic on sexual and reproductive health-related medical resources, this study adopted intentional sampling and recruited eleven women who experienced unintended pregnancy, as well as four medical staff working in the obstetrics and gynecology department. Semi-structured in-depth interview were conducted in the early stage of the epidemic in Hubei. In addition, this study also combed the posts of women with unintended pregnancy during the epidemic on the Chinese social network "Weibo" and "Xiao-Hong-Shu" to supplement the unintended pregnancy experience of women in different cities and situations.
The study found that during the pandemic, pregnant women's obstetric examination and medical treatment were affected to varying degrees, and the information gap between medical institutions and pregnant women was also exacerbated by the lockdown. From a feminist perspective, it examines the experience of women with unintended pregnancy during the epidemic, and analyzes the discipline of women's reproductive health in the family, medical field, and epidemic prevention and control, as well as the performance, concession and mediation of women's reproductive autonomy. This study presents the provision of reproductive health services and the transmission of medical information during the epidemic, in order to improve the way of information dissemination and medical service arrangements, improve quality and accessibility of medical care for pregnant women during the pandemic.

並列關鍵字

COVID-19 ； unintended pregnancy ； reproductive health ； qualitative research ； Hubei, China

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