生殖補助医療後に双胎妊娠した女性に対する助産ケアの認識

Midwives' Perceptions of The Care They Provide to Women with Twin Pregnancies Following Assisted Reproductive Technology

要旨

　目的：生殖補助医療（Assisted reproductive technology: ART）後に双胎妊娠した女性への助産ケアに対する助産師の認識を明らかにする．

　方法：助産師5名を対象にして，グループインタビューを実施した．データ分析は，Riessman（2008）のテーマ分析を用いた．

　結果：ART後に双胎妊娠した女性への助産ケアに対する助産師の認識について（a）【心が不安に占領される妊娠生活】（b）【双胎妊娠の負担の上に重なる高齢妊娠の重荷】（c）【出産をゴールに据えるがための理想と現実のギャップへの困惑】（d）【子どもとの距離を感じる母親】（e）【継続的な支援の必要性】（f）【ART後であることへの配慮の欠如】が見出された．

　結論：ARTヒストリーの情報を活用した継続的なケアの実践には至っておらず，ARTヒストリーを踏まえた助産ケアの知識の確立と普及の必要性が示唆された．

　Aims: To identify midwives' perceptions of the care they provided to women with twin pregnancies following assisted reproductive technology (ART).

　Methods: A group interview was conducted with five midwives who had provided midwifery care to women with a twin pregnancy following ART. Data was analyzed using Riessman's (2008) Thematic Analysis approach.

　Results: The following ideas emerged relating to the midwives' perceptions of the care they had provided: (a) pregnancy life dominated by anxiety; (b) the burden of an advanced maternal age pregnancy in addition to the pressures of a twin pregnancy; (c) bewilderment over the gap between one's ideal and reality due to picturing delivery as the goal; (d) mothers who felt distant from their children; (e) need for ongoing support ; and (f) lack of consideration for the fact that the mother underwent ART.

　Conclusions: Coherent midwifery care is not always provided to women with a history of ART. This suggests the need for improved knowledge among midwives and a more widespread practice of taking the patient's history of ART into consideration when providing midwifery care.