心理的な代理母親役を必要とした妊婦への援助

Psychological Role of Surrogate Mother to a Pregnant Woman

はじめに

　母性性は，幼少時の母親との関係を基盤とし，妊娠・出産・育児の過程を通して，子どもや夫，両親との関係の中で形成され発達する^1,2）。妊娠期は母親役割取得過程の第1段階であり，この時期に，妊婦は母親としての自己像を形成し，母親役割に関する認識を得，さらにその役割に必要な技術を取得して，母親としての準備を重ねていく^2）。

　今回，複雑な家庭環境で育ち，妊娠14週に父の死を体験した初妊婦（以下，A氏）の援助を経験した。A氏は，父の死の悲嘆作業を進めることができないだけでなく，「妊娠に自信がない」と訴え多くの身体症状を呈していた。A氏が家族の中だけで悲嘆作業を行ない，母親役割の取得を進めることは困難だと思われた。そこで，A氏に対して面接者（助産婦である研究者）が代理母親役割をとりながら，悲嘆や母親役割取得への援助を行なった。

　妊娠期の発達課題を達成する上で，代理母親をとることに，どのような意味があったのか分析したので報告する。

　This case study shows the development of maternal consciousness in a 35-year old woman in her first pregnancy. The woman was separated from her biological mother at birth, raised by stepmother, and experienced her father's death in the early period of pregnancy. Due to poor relationship with the stepmother, maternal consciousness was not developed at all. Not only could she not accept her pregnancy, her father, the only person she could rely on, and who was tender to her died because of sickness during her early period of pregnancy. She experienced depression at this time. Because it was difficult to accept both her father's death and the pregnancy, she wanted to find her biological mother instead of taking care of herself and the infant.

　The counselor (midwife) began the counseling by obstetrician's request to assist him because of difficulty to reach the real reason of her situation. The counselor listened the patient's story without judgment and expressed the counselor's feeling of sympathy and the intention to help her.

　All counseling processes were recorded under patient's consent and analyzed. A supervisor (psychologist) described the counselor's role as a temporary psychological surrogate mother and this role was useful. The counseling was carried out ten times and helped her accept her father's death and pregnancy, develop maternal consciousness, and prepare to be a mother.

　The pregnancy period is an important time to prepare to be a mother as well as to get knowledge and skills for motherhood, and to form self images as a mother. Therefore, many pregnant women want to ask their mothers to help to go through their pregnancy period and to get knowledge and skills to raise the child. It is suggested that the role as a temporary psychological surrogate mother is useful for helping pregnant women whose maternal consciousness is undeveloped to prepare psychologically and emotionally for motherhood and acquire childbearing skills.