出産に関する妊産婦の自己決定

Decision-Making of a Pregnant Woman about the Childbirth

要旨

　本研究においては，出産に関する妊産婦の自己決定のプロセスを明らかにするために419人の妊産婦を対象に産前・産後の2回にわたる質問紙法を実施した．その結果以下のことが明らかとなった．出産に関する質問紙は因子分析の結果3因子が抽出された．第Ⅰ因子「専門家の判断を必要と認める医療行為」，第Ⅱ因子「専門家の助言を必要と認める行為」，第Ⅲ因子「正しい知識をもつと対処できる行為」である．自己決定に影響を及ぼす要因として，出産施設，出産への関心度，知識，年齢が自己決定能力（産前と産後の自己決定の和）と有意な関係が認められた．出産に関する意思決定は産前と産後において各因子の内容により異なった．さらに産前・産後の意思決定の組み合わせから，「自己決定を通した」「自己決定の機会を得た」「不本意な意思決定をした」「自己決定しなかった」に分けられた．これらのパターンと出産に関する内容の3因子との間には，有意な関係が認められた．

Abstract

　The purpose of this study is to describe the prenatal and postnatal process of women's decision-making regarding their childbirth experiences. The subjects of the study were 419 women outpatients at hospitals, maternity hospitals or birth centers. Questionnaires were used to collect data before and after childbirth.

　The factors which influenced the process of decision-making are classified into three groups: medical care which needs professional medical judgement; care which needs professional advice; activities which can be conducted only with appropriate knowledge. Decisions made before and after childbirth are different because of these factors. Variables such as quality of care facilities, interest in childbirth, knowledge, and age are also highly related with the capability of decision-making. Combinations of decisions made before and after childbirth are categorized into four: made a decision by themselves before as well as after childbirth; given chances to make a decision; made a decision with reluctance; no decision by themselves. These combinations were significantly correlated with the three factors of childbirth experiences.