看不見說不出的「痛」－不孕婦女的失落、悲傷與自我調適之質性研究

詹豐毓

指導教授 ： 李佩怡博士

國立臺灣師範大學/教育學院/教育心理與輔導學系在職進修碩士班/碩士(2009年)

摘要

本研究旨在瞭解不孕婦女遭受不孕症的侵擾而對個人產生的影響、失落與悲傷反應，以及不孕婦女如何因應失落進行自我調適。本研究透過質性研究的深度訪談方式，共訪談三位不孕婦女，整理和分析所得之訪談資料，歸納研究結果如下：
一、不孕症對不孕婦女的影響：茫然與忙碌於醫療措施中、婚後家庭成為生育壓力的來源、朋友的關心是打擊也可能是真誠的關懷、生活因不孕而產生轉變或帶來不便、污名的偏見與否定如此沈重。
二、不孕婦女的失落與悲傷反應
（一）不孕婦女的失落內涵：失落了對醫療團隊的信任、自我價值感與生命意義的陷落、與夫家家人關係品質的轉變、人際關係的隔閡、治療副作用帶來健康的疑慮。
（二）不孕婦女的悲傷反應：包括認知層面、情緒層面、行為層面及靈性層面的悲傷反應
1、認知層面的悲傷反應：不孕婦女會認為無法懷孕是自己的錯、疑惑別人懷孕
為何如此輕而易舉，何以自己如此困難？容易否定自己而在做事前籠罩著事
情的結果可能會失敗的灰色想法、也會出現非常納悶沒有孩子的我，怎會在家中受盡欺負而委屈求全的想法。
2、情緒層面的悲傷反應：對不孕的降臨感到不知所措、否認且無法置信自己會
不孕、緊張與焦慮懷孕是否成功、生氣公婆以生育評估個人價值、受孕失敗
產生挫敗感、懷孕期望破滅的反覆煎熬、孤立無援的孤單感、受孕結果落空
後的沮喪與難過、承受生育壓力的暴躁情緒與不耐煩、生命中沒有孩子是個
遺憾。
3、行為層面的悲傷反應：藉由減少回夫家次數以逃避壓力情境、減少出席朋友
聚會場合、藉著忙碌轉移注意力，避免一再面對不孕的負面情緒、以哭泣宣
洩情緒。
4、靈性層面的悲傷反應：無法置信不孕怎麼會降臨在自己身上、疑惑別人懷孕
如此輕而易舉，何以我如此困難？內心納悶問蒼天：善良的我怎會無子？
三、不孕婦女因應不孕失落之自我調適：包括認知層面、情緒層面、行為層面及靈性層面的自我調適
（一）認知層面的自我調適：接受不孕的遺憾，正向思考無子的好處、重新找回
個人價值與自我認同、接受不孕的身體、告訴自己：已經努力嘗試懷孕，
問心無愧且不留遺憾、轉化眼光放在擁有的幸福。
（二）情緒層面的自我調適：以哭泣宣洩情緒，向先生表達難過的心情、抒發心
情，有助於療傷止痛。
（三）行為層面的自我調適：轉移焦點，避免陷入負面情緒的泥沼、將愛轉化至其他家人或學生身上、與家人共處、避開衝突與傷心的來源、主動和先生提出，不刻意配合醫囑而行房、藉由休閒運動抒解壓力、與同為不孕的病友談個人經驗、相知相守的兩人世界規劃。
（四）靈性層面的自我調適：父親生命的殞落是個點醒，學習自我照顧、因果輪迴觀為無子的遺憾找到出口。
本研究針對上述結果加以討論，並提出具體建議，以提供給不孕婦女、醫療相關人員、諮商心理人員及未來研究者之參考。

關鍵字

不孕症 ； 不孕婦女 ； 失落 ； 悲傷反應 ； 自我調適

並列摘要

The purpose of this study is to understand the impacts, loss and grief reactions that infertility has caused on women and how they deal and self-adjust with such feelings of loss. Through methods of qualitative investigations and in-depth interviews, this study in total holds interviews with three infertile women, and summarizes the findings as below:
1.The impacts of being infertile--which includes aimless self-immersion in medical measures, the pressure of bearing babies from the post-marriage family and friends, which could be not only concerns, the changes and inconvenience in life, and the unbearable weight on women out of the biased and negative stigma.
2.The loss and grief reactions of infertile women--which include the connotation of loss to infertile women and the grieving reaction at the surface level, the emotional level, the behavioral level and the spiritual level.
（1）The connotation of loss to infertile women includes the loss of trust for the medical team, the loss of sense of self-worth and meaning of life, the relationship change with the husband’s family the interpersonal barriers, and the suspicion of side-effects caused by the medical treatments.
（2）The grieving reactions of infertile women:
A. Their grieving reactions reflected in such exterior responses that “they were to blame for the infertility”, and “that they were puzzled by why pregnancy was so easy for others, but not for them”. They denied themselves easily, assuming negative outcomes of matters before even doing them. Furthermore, they started to wonder the reason why they should be bullied at home and started to believe they had to be wronged.
B. At the emotional level, they became at a loss of the fate of infertility, denying and rejecting that they were infertile. They were not only nervous and anxious whether they had successfully become pregnant or not, but angry at their in-laws for judging them based on fertility. Besides, they were frustrated after failed impregnation. The repeated disillusion for pregnancy tortured them. They suffered from the loneliness of isolation and helplessness. Frustration and sadness always followed the negative impregnation results. Therefore, they became emotional and impatient, and kept feeling regretted for not having children.
C. At the behavioral level, they escaped the pressuring situations by reducing frequency of visiting in-laws and attending friendly gatherings. Besides, they diverted attention by keeping busy to avoid having to face the negative emotions of infertility, and, furthermore, vented emotions by crying.
D. At the spiritual level, they began to disbelieve “how the fate of infertility had fallen upon them.” They were also puzzled “why pregnancy was so easy for others, but so difficult for them.” Their inner self wondered and asked God: “I am innocent, why can’t I bear a child?”
3. The self-adjustment of infertile women’s loss—which includes self adjustment at the surface level, the emotional level, the behavioral level and the spiritual level.
（1）Self adjustment at the surface level includes“accepting the lament of infertility and utilizing positive thinking to consider the advantages of not bearing children,＂“finding once again self-worth and identify,＂“telling self: I’ve tried my best to try to become pregnant, thus I have a clear conscience and no regrets,” and focusing on how blessed they are now.
（2）Self adjustment at the emotional level includes“venting emotions by crying and expressing to husband that sad emotion, and expressing emotions freely as it contributes to healing.
（3）Self adjustment at the behavioral level includes “shifting focus to avoid falling into the trap of negative emotions,”“spending time with family,＂ “reallocating love to other family members or students,”“avoiding sources of conflicts and hurt,”“being more active in sexual intercourse with husband rather than only following doctor’s orders,＂“depressurizing through recreational sports,＂“sharing experience with other infertile friends,＂and “making future plans for a world of the couple only.”
（4）Self adjustment at the spiritual level includes reducing the pressure from the inspiration caused by the death of the interviewer’s father, which was a reminder for her to learn how to take care of herself, and from which she found liberation by considering infertility as a result of karma.
This study further discusses the results described above and proposes specific recommendations to provide future reference for affiliated medical staff, infertile women, associated friends and family, psychological advisors and future researchers.

並列關鍵字

infertility ； infertile women ； loss ； grieving reaction ； self-adjustment

參考文獻

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