医療技術の発達が出産のあり方に与えた影響（第1報）—出産と医師・助産師の役割および協力関係の比較

The Influence of the Development of Medical Technology on Childbirth(The First Report): A Comparison of the Roles and the Cooperative Relationship of Doctors and Midwives

要旨

　現在病院で行われている医療化された出産は、「非人間的」とまでいわれるようになってきた。そこで、医療技術の発達によって病院出産がどのように変化してきたのか、またそれに伴い出産場面における医師・助産師の役割および協力関係の変容を明らかにすべく調査を行った。比較対象は産科領域に医療機器・技術が広く普及される以前の1968年と1996年である。

　その結果、1．約30年の間に医療技術の高度化が急速に進み、出産の安全性はほぼ確保できたが、反面画一的・機械的、流れ作業的な出産に変容してきた。2．出産場面における医師と助産師の関係は、医師が「助産」における中心者となり、助産師は周辺者へと位置づけられるようになった。3．役割上の対等な関係は希薄となり、医師と助産師は従属的な関係が顕著になってきた。

　今後は医療技術および高度化に関して正当に評価し、出産のあり方を検討することが課題である。

Abstract

　The medically-intervened childbirth being conducted in hospitals today has even come to be called "inhuman". Therefore, we researched how the development of medical technology has changed childbirth in hospitals, and how it has affected the roles and the cooperative relationship between doctors and midwives at delivery scenes. A comparison was made between the year of 1968, when medical instruments and technology were not yet wide-spread in the field of obstetrics, and the year of 1996.

　The results: 1. While the rapid advancement of medical technology has made possible a usually safe delivery for these 28 years, the childbirth itself has changed to be more like a uniform, mechanical conveyor system. 2. As for the relationship between doctors and midwives at delivery scenes, doctors have become ranked as the central figures, and midwives as peripheral ones. 3. The equal relationship between these two roles has faded, and the pecking order between doctors and midwives has become conspicuous.

　From now on, we need to evaluate medical technology and its advancement properly, and examine what childbirth ought to be. This is the pending problem that we are facing today.