出産の医療化論再考

「妊婦中心の健診」と助産師教育・卒後研修にみる女性の抵抗の限界

抄録

　This paper examines the theory related to the medicalization of childbirth by focusing on the interaction between medical institutions and pregnant women. Drawing upon the work of Claudine Burton-Jeangros (2011), as well as based on in-depth interviews with26 women who have recently given birth and 11 midwives in Japan, I attempt to show how medical surveillance is achieved by the midwifery system and how difficult it is for individual women to resist the surveillance.　Surveillance is achieved through the following techniques. First, unlike medical doctors, a midwife can become more familiar with a pregnant woman because they are both female. Second, midwives get the family (husbands and older children) to carefully monitor the woman’s health and dietary practices and make them suitable agents to the midwives. Finally, exam questions under the system of national certification in midwifery education are solicited from midwives who conduct pregnant women’s checkups. In this system, the more the pregnant woman confesses her distress and dissatisfaction to the midwife, the more accurate the surveillance becomes.　Therefore, it can be concluded that prenatal checkups by midwives are a tool for medicalization rather than for de-medicalization of childbirth.