Analysis of Process of Forming the "Ability to Become a Parent" : What Relation is Established Between a Pregnant Woman and a Midwife in the Initial Checkup? (Notes)

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(1)人間看護学研究. 5:73-79(2007). 73. 研究ノート. Analysis of Process of Forming the "Ability to Become a Parent" —What Relation is Established Between a Pregnant Woman and a Midwife in the Initial Checkup? —. "School 'International. Mariko Fujii1), Fumiko Hinokuma 2), Akiko Tubota 2) of Human Nursing The University of Shiga Prefecture University. of Health. and Welfare. Graduate. School. Background Today, the problem concerning the child care, like a Child Abuse, is a social task. As a result, the research to solve these problems is increasing, too. However, most of those focus on to the support after the child is born, the study from the pregnancy period is a little. Especially, there is no thesis that focuses on to the relation to others in order to nurture the "ability to become a parent" , at the pregnancy period. Objective The purpose of this study was to verify how midwife is involved with pregnant women, as well as learn about the relationship established between pregnant women and midwife. Method 1. A total of 26 women were observed and recorded with VTR during their clinical checkups at the maternity home in N city. 2. Three pregnant women who felt satisfied with in their first checkup were selected. 3. All contents of verbal and non-verbal communications between the pregnant women and a midwife were described a verbatim form and analyzed qualitatively. Results The three pregnant women all had worries, anxieties and troubles. They were expressed in the course of conversation with the midwife. Pregnant women were never rushed into the examination room, but moved at their own pace, and were given ample time to think and remember as they talked. They were able to allow the midwife to understand not only the physical changes involved in their pregnancy, but also their concerns about life in general. On the other hand, the midwife asks pregnant women clear, direct questions regarding their pregnancy and health. However, regarding anxieties and doubts, the midwife asked discreetly, and never forced the women to speak of their feelings. She kept her eyes on the women, and nodded with empathy in perfect timing. Conclusion The relationship established between midwife and pregnant women was one of trust (dependency). Key words ability to become a parent, midwife-pregnant woman relationship, a maternity home, trust (dependency). 2006年9月30日連絡先:藤. 受付、2007年1月9日. 井真理子. 滋賀県立大学人聞看護学部住. 所:彦. 根市八坂町2500. e-mail : mfujii@nurse.. usp. ac. jp. 受理.

(2) 7 4. I n t r o d u c t i o n S i n c earound1 9 9 0， n u c l e a rf a m i l i e sh a v ei n c r e a s e d， andt h e" c u l t u r eo fb e a r i n gandr e a r i n gc h i l d r e n "i s a v ef e w e r d e t e r i o r a t i n g . Asar e s u l t，womennowh o p p o r t u n i t i e st obecomef a m i l i a rw i t hc h i l d r e a r i n g， which g i v e s them f e e l i n go f burden and s t r e s s h e d e v e l o p m e n t o f about i t . As a r e s u l t， t c h i l d r e a r i n ge nvironment sandc h i l d r e a r i n gs u p p o r t ;2 0 0 0， systemsi sc u r r e n t l yunderway ( K a t oe ta l， Fukudae tal ， ;2 0 0 5，Maedae ta l， ;2 0 0 5，Haradae t al ， ;2 0 0 6，日i r a o k ae tal ， ;2 0 0 6， Nakayamae ta l， ; 2 0 0 6 ). u r t u r i n gt h e" a b i l i t yt obecomeap a r However，n e n t "r e q u i r e ss u p p o r tn o to n l ya f t e rt h ec h i l di s l s od u r i n gpregnancy， t h ep r e p a r a t o r y born， buta s t a g e . B e l s k y( 1 9 8 4 )s t a t e st h a tp a r e n t i n gd u r i n g t h en u r t u r i n gp h a s ei s" d e t e r m i n e d by c h a r a c t e r i s ft h ec h i l d， ando fc o n t e x t u a l t i c so ft h ep a r e n t， o subsystems o fs o c i a ls u p p o r t . " Support from t h e n e s u r r o u n d i n g si si n c l u d e di nt h es o c i a lnetwork，o o ft h ec o n t e x t u a l subsystems o fs o c i a ls u p p o r t . Nursing i s an o c c u p a t i o nt h a tc a nb ec o n t i n u a l l y i n v o l v e d，fromt h e pregnancy p h a s eo n . However， t h ec o n t e n to fi n v o l v e m e n th a sn e v e rb e e nc l a r i f i e d . st h e' f i r s ts t e pi nc l a r i f y i n gt h e T h e r e f o r e， a p r o c e s so fbecomingp a r e nt st h ath e a lt h ywomengo throughd u r i n gt h ec o u r s eo fpregnancyandc h i l d h i sp a p e ra n a l y z e di n s t a n c e si n which r e a r i n g， t pregnant women were s a t i s f i e dw i t hc h e c k u p s， i n o r d e rt ov e r i f y hown u r s e s( m i d w i f e )a r ei n v o l v e d sw e l la sl e a r n aboutt h e w i t hpregnant women， a r e l a t i o n s h i pe s t a b l i s h e d between p r e g n a n t women andm i d w i f e .. Method 1 )I n v e s t i g a t i o ns u b j e c t P a r t i c i p a t e d and o b s e r v e dh e a l t hc h e c k u p so f2 6 n c l u d i n ga womena tam a t e r n i t yhomei nN C i t y，i pregnant woman v i s i t i n gf o rt h ef i r s tt i m e and a motherwho broughth e rc h i l df o rac h e c k u p . Of t h e s e，t h r e e pregnant women who p e r s o n a l l ys a i d t h e yweres a t i s f i e dwitht h ec h e c k u pwerec h o s e na s a n a l y s i ss u b j e c t s . 2 ) Dataanddurationo ft h estudy 0 0 1 -February2 8，2 0 0 1 February 1，2 3) Researchd e s i g n. 藤井真理子、日限ふみ子、坪田. 明子. We employ " p a r t i c i p a t i n go b s e r v a t i o n "b a s e d on t h ep h e n o m e n o l o g i c a lm e t h o d . 4) Procedure 1 n t e nt o ft h es t u d y was e x p l a i n e dt o pregnant womend u r i n gt h e i rw a i t i n gt i m ea tt h em a t e r n i t y l 'sc o n s e n t， t h ei n v e s t i g a home. Witht h ei n d i v i d u a t o rs a ti nd u r i n gt h ec h e c k u pw i t ht h e pregnant b s e r v e dt h ec o n v e r s a t i o n s， f a c i a le x p r e s woman， o s i o n s and b o d i l yg e s t u r e so ft h em i d w i f e and t h e o o kn o t e sa sn e e d e d . At t h e same woman， and t h ee n t i r ec h e c k u pp r o c e d u r ewasr e c o r d e don t i m e，t VTR，w h i l ep r o t e c t i n gt h ep r i v a c yo ft h es u b j e c t s . 5) E t h i c a lc o n s i d e r a t i o n s We e x p l a i n e dt h eaim o fours t u d yt ot h ep r e g nantwomen a tt h em a t e r n i t yhome. We g a t h e r e d t h ed a t afromt h ewomenwhoa g r e e dw i t ht h eaim o fours t u d y .. R e s u l t sand d i s c u s s i o n A l lt h r e es u b j e c t swereh e s i t a n taboutc o n t i n u i n g pregnancy， were u n a b l et od e c i d e on a d e l i v e r y n x i o u s， and had w o r r i e sr e g a r d i n g p l a c e， were a t h eh e a l t ho ft h e i rf a m i l y members. However， t h e s et o p i c sd i dn o tcomes t r a i g h to u tfromt h eb e g i n n i n go ft h ec h e c k u p . Thesewere spoken o fa t si fi nt e n d e d， du r i n gt h e o p p o r t u n et i m i n g， a c o u r s eo ft h ec o n v e r s a t i o nw i t ht h em i d w i f e . Case 1 Ms. M ( 3 4 ) wasr a i s e da st h eyoungesto ft h r e e c h i l d r e n . She i sa l r e a d y a mother t ot h r e ec h i l d r e n . She g a v eb i r t ht oh e rs e c o n dandt h i r dc h i l d r e na tt h i sm a t e r n i t y home. When s h e became t had b e e nt h r e e pregnant f o rt h ef o u r t ht i m e， i y e a r ss i n c eh e rt h i r dc h i l d . Shehada l r e a d yn o t i f i e dt h em i d w i f eo ft h epregnancyw i t hanew-year t was n o tu n t i lo n e month p o s t c a r d . However， i l a t e r， and 1 7 weeks i n t ot h e pregnancy， t h a ts h e v i s i t e dt h em a t e r n i t y home. The c h e c k u p began si ft h em i d w i f ewaswelcominga v e r yn a t u r a l l y， a m a r r i e ddaughterwhowasv i s i t i n g . Ms. M s a i d，i nab r i g h t，s w e e t and d e p e n d e n t 1 went t ot h eh o s p i t a lb e f o r e 1came h e r e v o i c e， " l o o dt e s t s ( t h em a t e r n i t y home)， and had my b a y i n g d o n e . " Them i d w i f eansweredw i t has m i l e，s "Okay，s oy o u ' r ep r e g n a n t . Witht h eb i r t h r a t ef a l t ' s good news." l i n g and b a b i e sb e i n g wanted， i.

(3) 「親となる力 Jを形成する過程の分析. 7 5. Whent h ec h e c k u pbegan，Ms. M gradu a l l yr a i s e d h e rt o n eo fv o i c eands a i d "myh u s b a n d ' "h e ' sn o t immediate1ya g r e e i n gw i t hme( a b o u tg i v i n gb i r t h ) . A l lh es a y si s' w h a ts h o u 1 dwed o ' . . . "t ot h emidw i f e， a si fs h e were c o n s u l t i n gh e r own m o t h e r . The midwife nodded and 1 i s t e n e d，a ss h er e c o r d e d i n f o r m a t i o nont h em e d i c a 1c h a r t . However，when Ms. M s a i d" 1 became angry a t my h u s b a n d ' s words， 1 i k e' t h r e ei se n o u g h 'o r' w ec a n have an o t h e r baby when we want o n e '，" t h e midwife s t o p p e dw r i t i n g and p u t on a s t e r ne x p r e s s i o n . However，when Ms. M wasf i n i s h e dt a 1 k i n g，t h e midwife c a 1 m 1 y answered " W e l l，wheny o u ' r ep r e g nant with a baby， t h i n g sw i l l work t h e m s e 1 v e s o u t . " Ms. M begans p e a k i n gabouth e rf r i e n d s， s a y i n g" 1a s k e d around ( a b o u tt h e i rf e e 1 i n g s )t o f r i e n d s who g a v eb i r t ht oaf o u r t hc h i 1 d . " The midwife， w h i 1 ec o n t i n u i n g with t h ec h e c k u p， s a i d "whatd i dt h e ys a y ? 1b e tt h e ys a i dt h e y1 0 v et h e i r b a b i e st od e a t h ! "w i t has m i 1 e， a si ft os t i raf e e 1 i n go fattachmentt ot h eb a b y . Then，t h e yt a 1 k e d aboutMs. M'sf r i e n d ' sf o u r t hp r e g n a n c y . Toward t h ee n do ft h ec h e c k u p， Ms. M， with h e r head down， muttered " 1 si to k a y ? "i n as m a l l v o i c e . Themidwifer e s p o n d e dwitha1 i g h t"hmm?" and ] ¥ 在s .M s a i d" 1 si to k a y ? "a g a i n . S i n c et h i s q u e s t i o n was t o t a l l yo u to fc o n t e x tw i t ht h ec o n v e r s a t i o nupt ot h a tp o i n t，wewerec o ' n f u s e df o ra s e c o n d，butt h e nt h emidwifeq u i e t 1 yanswered" 1 t ' s okay，"t h e nc o n t i n u e dt ot a 1 ko ft h ea d v a n t a g e sf o r ac h i 1 dt o havemanys i b 1 i n g s . Ms. M seemedt o f e e 1 c o m f o r t a b 1 e w i t h what t h e midwife was s a y i n g， and 1 0 0 k e dh e rh a p p i e s ta tt h i s moment s i n c et h eb e g i n n i n go ft h ec h e c k u p . And，a si fr e membering h e rc h i 1 d r e a r i n g up t ot h i sp o i n t， s h e 1 i s t e da d v a n t a g e sa f t e ra d v a n t a g e so fhavingt h r e e c h i 1 d r e n . Andt h e n， i nt h eend， s h es a i d" I t was b e c a u s e1wantedt ocomes e eyoua f t e r1hadmade t h ed e c i s i o nt ohavet h i sbaby，"and1 e f tt h em a t e r n i t yhomew i t har e f r e s h e d1 0 0 konh e rf a c e，h a v i n gt o 1 dt h em i d w i f eh e rt h o u g h t s . 句. 句. Case 2 Ms. A i s2 9y e a r so l d . T h i si sh e rs e c o n dp r e g nancy， ands h ehasno d e l iv e r ye x p e r i e n c e . Came t ot h e maternity home 2 2 weeks i n t oh e rp r e g n a n c y . She r e c e nt 1 y moved from a n o t h e rp r e fe c t u r e . B e f o r et h e move， Ms. A had r e c e i v e d. pregnancy examination a tah o s p i t a l . After t h e move， s h ea 1 s o had gone t oah o s p i t a ， l but had communication t r o u b 1 e s with t h ed o c t o r :she was a p p a r e n t 1 y n o t s a t i s f i e d with h e r pregnancy e x a m i n a t i o n . " 1 t( t h ee x a m i n a t i o n ) wasc a r r i e don a tt h ed o c t o r ' sp a c e ' " 1was v e r ya n x i o u s " ' "s a i d s h e， s t o p p i n gt ot h i n ka f t e re v e r yp h r a s e， and s p e a k i n gs l o w1 y . She 1 e a r n e do fmat e r n it y homes v i at h e1 nt e r n e t and books， and came t ot h i s home. Regardingi n s t r u c t i o n sond i e tandhowt oc a r r y ond a i 1 y1 i f e，Ms. A ' sr e s p o n s ewasmain1y" 1s e e，，a nd s h e seemed t ob ea b s o r b i n gknow1edge from t h em i d w i f e . Toward t h e end o ft h ei n s t r u c t i o n g iv i n g， Ms. A began s p e a k i n go fh e ra n x i e t y about h e r and h e r husband n o t having r e a c h e da c o n s e n s u sr e g a r d i n g where s h e wou1d have t h e b a b y . " T ot e l lyou t h et r u t h ' " 1h a v e n ' td e c i d e d t ohavet h ebabyh e r ey e t . . . 1wou1d1 i k et o， b u t . . . My husband… U m… (He i s )w o r r i e d about emergency s i t u a t i o n s， b e c a u s et h i si s a maternity home. And，t h i s (showsap i e c eo fp a p e r )・・・ (My husband) wantst o askq u e s t i o n s " ' "s h es a i d， t a k i n go u tamemo. Themidwifenoddedandl i s t e n e d t h ee n t i r et i m ewithoutr u s h i n gh e ro rc u t t i n gh e r o f f . A f t e rs h ewasdonet a 1 k i n g，t h emidwifea n swered e a c h o f h e r q u e s t i o n s i n an e a s y t o u n d e r s t a n d way. And g a v eh e rs p e c i f i ca d v i c e on improvementss h en e e d st omakei nh e rd a i 1 yl i f ei n o r d e rt ohavean a t u r a 1d e 1 i v e r y . F i n a l l y，t h emidw i f eadded， " I fmaternityhomesw e r e n ' tc a p a b 1 eo f h a n d 1 i n g emergency s i t u a t i o n s， midwives c o u 1 d n ' t c o n f i d e n t 1 y have women g i v e b i r t h， s o d o n ' t worry." Ms. A seemedv e r ys a t i s f i e dwhenshe1 e f t t h ee x a m i n a t i o nroom. Case 3 Ms. N， 3 3y e a r so l d . T h i si sh e rt h i r dp r e g n a n c y . She v i s i t e dt h em a t e r n i t y home 2 5 weeks i n t ot h ep r e g n a n c y . T h i si sc o m p a r a t i v e 1 y1 a t ef o r af i r s tv i s i t . Af r i e n di n t r o d u c e dh e rt ot h i s mat e r n i t y home，and s h ev i s i t e d with t h ef r i e n d and h e rt h r e e y e a r 0 1 dd a u g h t e r . Ms. N ' sp a r e n t shave a 1 r e a d yp a s s e daway. Herf a t h e rd i e do f1ungc a n c e ri nt h esamey e a rh e rf i r s tc h i 1 dwasb o r n . The y e a rf o l l o w i n gt h a t，h e rmotherd i e do fovaryc a n c er . " B e c a u s eo fa l lt h i s， 1 s t a y e ds o busy". (Lookinga th e rd a u g h t e r ) 1f e e 1s o r r yf o rhows h e.

(4) 7 6. musthavef e l ta tt h a tt i m e "s a i dMs. N . Thep a r e nt so fh e r hu sband ha v ea l r e a d yp a s s e d away a s . L i s t e n i n gt ot h i s， t h em i d w i f ep u tas u r w e ll p r i s e de x p r e s s i o nonh e rf a c e，anda d v i s e dh e ri na s t r o n gt o n e : "You n e e dt o pay a t t e n t i o nt o your a i d d i e tt op r e v e ntd i s e a s e . " Hearingt h i s，Ms. N s " T h e r ea r emanyf o o d smyhusbandd o e s n ' tl i k e . . . h ed o e s n ' tl i k ev e g e t a b l e s . . . and 1c a n ' t co o kv e r y w e l l . . . "i nana p o l o g e t i cway. Themidwifed i dn o t u ti n s t e a d s c o l dh e ro rt r i e dt oe n c o u r a g eh e r， b I 'v e began t oq u i e t l ys p e a ko f own e x p e r i e n c e s . " u t 1s t i l ll e a r n someb e e nc o o k i n gf o r4 0y e a r s， b t h i n g new e v e r yd a y . For t h ef i r s t two t ot h r e e o u l d n ' tdoanythingw i t h o u tac o o k b o o k . y e a r s，1c 1s t i l l open o n e upfrom t i m et ot i m e . " And t h e n a d d e d， "80me p e o p l ea r e good a tc o o k i n g， some fy o u ' r en o t，t h e nyouc a ng e tb e t p e o p l ea r e n ' t . I a y i n g t e rl i t t l e by l i t t l e . " Ms. N l i s t e n e d， s i t har e l i e v e de x p r e s s i o n " r e a l l y ? "o r" i st h a ts o・・・" w onh e rf a c e . T h i st r i g g e r e dar a p i d f i r eo u t p o u r i n g u c ha s how h e r husband i sa o fh e rh a r d s h i p s， s a t so u tal o t and s h ei sw o r r i e d w o r k a h o l i c， he e a b o u th e a l t hp r o b l e m s from h i se a t i n go u t， how s h ee n d e dupu s i n gc o n t r a c t i o n i n d u c i n gdrugst h a t s h er e a l l yd i d n ' t want t ou s e when s h e had h e r e r mother was s i c ks os h e f i r s t baby， and how h hadnos u p p o r tandi twasv e r yhardonh e r . h es a i d" 1wish1c o u l dh a v el e a r n e dabout And，s c h i l d r e a r i n g from my m o t h e r . 1 thought t h a t maybe i f 1came h e r eC m a t e r n i t y home)， 1might g e tt ol e a r n al o t . . . "i nas m a l l，s w e e t，d e p e n d e n t t o n e . Ms. N had gone t oah o s p i t a lb e f o r eh e rf r i e n d ， l t o l dh e raboutm a t e r n i t yh o m e s . Att h eh o s p i t a s h eseems t oh a v eb e e ni n s t r u c t e dt oc o n d u c tv e r y . "During my p r e v i o u s s t r i n g e n tw e i g h tc o n t r ol pregnancy1k e p tmyw e i g h ti n c r e a s ea t1 0kg，b u t oe a tc o n s t a n t l y . d u r i n gt h i s pregnancy， 1want t Thed o c t o rt e l l smet on o tg a i nw e i g h t，andwhen 1t e l lm y s e l ft h a t1s h o u l d n ' te a t，t h a ts t r e s sc a u s e s me t oe a tm o r e . T h i si sa l l making me a l i t t l e d e p r e s s e d . . .I 'm j u s ta n x i o u s . 1c a n ' tt e l lanybody t h a tI 'm i nt h i sd e p r e s s e ds t a t e . . . 1c o u l d n ' tc o n s u l t o n ' t t h ed o c t o ra tt h eh o s p i t a le i t h e r . . . Now， 1d a ttwom e a l sad a y "wereh e r e a tb r e a k f a s t，and1e c o m p l a i n t sr e g a r d i n gt h eh o s p i t a l 'swayo fh a n d l i n g h e rs i t u a t i o n . The m i d w i f e nodded and l i s t e n e d . When Ms. N was f i n i s h e d， t h e midwife. 藤井真理子、日曜ふみ子、坪田. 明子. i m m e d i a t e l y began a s k i n g about h e rc o n d i t i o n， weighedh e randt h e np a l p a t e dh e rabdomen，a si f t h i s were normal p r o c e d u r e . We were a b i ts u r . aby t h i s . However， when t h ee x a m i n a t i o n p r i s e h em i d w i f es p o k eq u i e t l yt o Ms. N . was o v e r， t " E a t i n gi st h emostimportantt h i n gi nt h el i v e so f humans. E a t i n gi swhatmakesyouh e a l t h y . E a t n l i k em e d i c i n e，i s somethingyouh a v e i n gr i g h t，u ， l n a t u r a l t o work a te v e r yd a y . To h a v e norma a v et om a i n t a i n a good d i e t a r y d e l i v e r i e s， you h h a b i te v e r y day t ob u i l d up your body Cmake i t h e a l t h y )f o rd e l i v e r y . From l i s t e n i n gt o you， 1 t h i n kt h eb i g g e s ti s s u ef o ryourhusbandandc h i l oe a tb r e a k f a s tt o o . d r e ni s' d i e t ' . 80，1wantyout I f a mother d o e s n ' te a tb r e a k f a s t， c h i l d r e nw o n ' t t . i n gi nt h emorning. Ande n j o y i n gm e a l s e n j o ye a i sv e r yi m p o r t a n t， "s h es a i d，l i k eamotherg i v i n g a d v i c et oad a u g h t e r . Themoments h ewast o l dt o u r p r i s e dandr e l i e v e d e a tb r e a k f a s t， Ms. N putas i t ht h em i d w i f e ' s e x p r e s s i o n on h e rf a c e . And， w I fyou have any a n x i e t i e so rw o r r i e s， you words " c a nc a l lh e r e anytime，"h e re x p r e s s i o nb r i g h t e n e d upe v e nロlOr e . The t h r e e pregnant women a l l had w o r r i e s， a n x i e t i e sandt r o u b l e s . However，byt h et i m et h e h e ye a c hl o o k e d 3 0 m i n u t ee x a m i n a t i o n was o v e r， t much h a p p i e r . And a l lt h r e es a i d" 1 was a b l et o s a ya l lt h a t1wantedt osay，"' ' I 'm g l a d1wasa b l e " and"Pmg l a dt h a t1came t ot a l kt ot h em i d w i f e， h e r eC m a t e r n i t yhome)." Whyd i dt h e ymaket h e s e comments? h e r ei so n eg r e a td i f f e r e n c ei nt h e F i r s to fa l l， t system and a m e n i t i e so ft h em a t e r n i t y home and h e r e t h o s eo fh o s p i t a l s . 1 nt h em a t e r n i t yhome，t i s no r e c e p t i o nd e s k， and i t ' s system t h a te n t e r s e x a m i n a t i o n room when o n e ' st u r nc o m e s . The t i m e r e q u i r e d f o r examination i s about 2 0 3 0 m i n u t e s . The m a j o r i t yd u r i n go fe x a m i n a t i o ni s i k ead i e t . s p e n tont h ei n s t r u c t i o n so fd a i l yl i f e， l Them a t e r n i t yhomep r o v i d e sanatmospheret h a ti s e x t r e m e l ys i m i l a rt ot h ed a i l yl iv i n ge nvironment h em i d w i f ei s o fp r e g n a n t women. Moreover， t wearings w e a t e rands k i r t，p u t t i n gonaa p r o n . Then e x tf o c u si son t h er e l a t i o n s h i pe s t a b l i s h e d b e t w e e nt h em i d w i f eandpregnantwomen. i r e c t The m i d w i f ea s k s pregnant women c l e a r， d q u e s t i o n sr e g a r d i n gt h e i r pregnancy and h e a l t h ..

(5) 「親となる力 Jを形成する過程の分析. 7 7. R e l a t i o n s h i po fT r u s t (. ¥. M i d w i f e. ')一二>. ノ<二一. •A s s u r et h a ty o uc a ns p e a k e n o u g ha n dy o ua r ei ny o u r u n a f f e c t e ds e l f . .A s s u r et oc o n t i n u e ~ p r e g n a n c y II. •F e e lt h em i d w i f ea c c e p t m . mea s1a •F e e la si fIh a v eb e e n e m b r a c e db ymym o t h e r .. As p a c et h a tw o u l dg i v eaf e e l i n go fp e r s o n a ll i v i n g F i g u r e1 R e l a t i o n s h i p sb e t w e e nt h eP r e g n a n tWomenandt h eM i d w i f e i n c ed e l i v T h i si st ob ee x p e c t e da sas p e c i a l i s t，s e r ya tt h ematernityhomei si m p o s s i b l eu n l e s st h e pregnantwoman i sh e a lt h y . However， r e g a r d i n g a n x i e t i e sandd o u b t s，t h emidwifea s k e dd i s c r e e t l y， andn e v e rf o r c e dt h ewoment os p e a ko ft h e i rf e e l i n g s . When pregnant women began s p e a k i n go f d o u b t sr e g a r d i n g whether t oc o n t i n u e with t h e pregnancyo rn o t，a n x i e t i e sr e g a r d i n gt h eh e a l t ho f husbands and c o n c e r n s r e g a r d i n g t h e d i e t o f c h i l d r e n，t h emidwifen e v e ri n t e r r u p t e do rn e g a t e d t h e m . Shek e p th e re y e sont h ewomen， andn o ι d e d with empathy i np e r f e c tt i m i n g . When s h e g a v ea d v i c e， h e ra d v i c ewass p e c i f i c， t e l l i n go fh e r own e x p e r i e n c e si nt h em a t t e r . Her t o n e was sometimesk i n d， sometimess t r o n gands e r i o u s . On t h eo t h e rhand， pregnantwomenweren e v e r r u s h e di n t ot h e examination room， but moved a t t h e i r own p a c e， and were g iv e n ample t i m et o t h i n k and remember a st h e yt a l k e d . They were a b l et oa l l o wt h e midwife t o understand n o to n l y t h ep h y s i c a lc h a n g e si n v o l v e di nt h e i rpregnancy， buta l s ot h e i rc o n c e r n saboutl i f ei ng e n e r a . l The women were on t h ee d g eo ft h e i rs e a t st oh e a r e v e r ywordo fa d v i c eg i v e nbyt h em i d w i f e . From t h e i rr e l a x e de x p r e s s i o nandt o n eo fv o i c e， wes u r mised t h a t pregnant women were f e e l i n gc o m f o r t a b l ea tb e i n ga c c e p t e da st h e ya r e . T h e r e f o r e， i ti sc o n c l u d e dt h a tt h er e l a t i o n s h i p e s t a b l i s h e d between a midwife and a pregnant woman during h e a l t hc h e c k u p si sl i k et h a t shown. i nF i g u r e1 . The m idwife l i s t e n s and g i v e sa d v i c e n o to n l ya ss p e c i a l i s t s， but a l s oa s neighbors， guarant e e i n gap l a c e wh e r e pregnant women c a n t a l kc o m f o r t a b l y and a tl e n g t h . I nt h i sp l a c e， pregnantwomen s p e a k with midwife a st h e i rn o r mal s e l v e s， e x p o s i n gt h e i rw o r r i e s， d o u b t s， f i x a t i o n sanda n x i e t i e s，andt h e ye x p e r i e n c ecomforta s i fi nt h ep r e s e n c eo ft h e i rownm o t h e r s . The r e l a t i o n s h i pe s t a b l i s h e d between midwife and pregnant women who were s a t i s f i e d with t h e i r h e a l t h c h e c k u p was one o ft r u s t ( d e p e n d e n c y )， e v e n thoughi twast h e i rf i r s tv i s i t . I ti ss a i dt h a t becoming a p a r e n tc h a n g e so n e ' s p e r s o n a l i t y (Kashiwagi e t al . ; 1994， U j i i ee t al . ; 1 9 9 4，O n o d e r a ;1 9 9 7 ) . T hesec h a n g e shavemucht o do with t h es u p p o r tp r o v i d e d by t h e surrounding p e o p l e . The d e p e n d e n c yr e l a t i o n s h i p with midwife c a nb ec o n s i d e r e do n eformo fsuchs u p p o r t .. Conclusion During t h ef i r s tv i s it o ft h e pregnancy h e a lt h c h e c k u p，midwifef a c e dpregnantwomena ss p e c i a l i s t s，a sn e i g h b o r s，anda smotherf i g u r e s . Ont h e o t h e rhand， pregnantwomen e x p o s e dt h e i rt r u e， normal s e l v e s， f e e l i n ga sc o m f o r t a b l ea si fi nt h e p r e s e n c eo ft h e i r own m o t h e r s . The r e l a t i o n s h i p e s t a b l i s h e d between midwife and pregnant women wasoneo ft r u s t( d e p e n d e n c y ) ..

(6) 7 8. 藤井真理子、自慢ふみ子、坪田. しi m i t a t i o n so ft h i ss t u d y S i n c et h i sr e p o r td e a l s with o n l yt h r e es u b j e c t s， h er e l a t i o n s h i p g e n e r a l i z a t i o ni sd i f f i c u l t . A l s o， t d e a l tw i t hh e r et a k e sp l a c ea to n l yo n eo ft h emany p h a s e so fp r e g n a n c y . The e f f e c t so fs u c har e l a t i o n s h i ponp r e g n a n twomenmustb eo b s e r v e dl o n g i t u d i n a l l y .. R e f e r e n c e s FukudaNaoko. e t al .( 2 0 0 5 ) . Developmento fa Risk Assessment Form P r e v e n t i o no fC h i l d AbuseandN e g l e c t .J a p a n e s eS o c i e t yf o rP r e v e n t i o no fC h i l d Abuse andNe g l e c t， 7(2) ; ， 1 2 0 0 5 . 2 3 8 2 5 HaradaM. e ta . l( 2 0 0 6 ) . ContinuousAbuseP r e v e n t i o n and Support from t h e p r e n a t a l p e r i o d . J a p a n e s eS o c i e t yf o rP r e v e n t i o no f 0 7 1 1 3 . C h i l dAbuseandN e g l e c t， 8(1); 1 r i k o .e t al . ( 2 0 0 6 ) .C o n s t r u c t i o no f Hiraoka， E C h i l d Abuse P r e v e n t i o n system a tp r e n a t a l p e r i o d :P r e p a r a t i o no fP r e n a t a lC h e c k l i s t . J a p a n e s eS o c i e t yf o rP r e v e n t i o no fC h i l d 1 9 1 2 4 . AbuseandN e g l e c t， 8(1)，1 Kashiwagi K e i k o . e ta l . ( 1 9 9 4 ) . Becoming a “. 明子. P a r e n t and P e r s o n a l i t y D e v e l o p m e n t : A L i f e s p a nD e v e l o p m e n t a lV i e w . The J a p a n e s e J o u r n a lo fD e v e l o p m e n t a lPsychology ， 5(1)， 7 2 8 3 Kato Yoko. e t al . ( 2 0 0 0 ) .R i s k Assessment t o i d e n t i f ys e v e r i t y and R i s kl e v e l s . J a p a n e s e S o c i e t yf o rP r e v e n t i o no fC h i l d Abuse and 9 8 6 . Ne g l e c t， 2 (1)， 7 Maeda K i y o s h i .e t al . ( 2 0 0 5 ). Managing C h i l d AbuseC a s e sa tCommunityH e a l t hC e n t e ri n A i c h i P r e f e c t u r e C u r r e n t s t a t u s and P r o b l e m s .J a p a n e s eS o c i e t yf o rP r e v e n t i o no f ;3 2 8 3 3 5 . C h i l dAbuseandN e g l e c t， 7(3) NakayamaEmiko. e ta .( l 2 0 0 6 )D e n t a lH e a l t ho f Ab u s e dC h i l d r e nt a k e ni nt o Fukuoka C it y C h i l d r e n ' s Advisory C e n t e r . J a p a n e s eS o c i e t y f o r P r e v e n t i o n o f C h i l d Abuse and 5 9 1 6 4 . N e g l e c t， 8(1)，1 Onodera Atsuko. e t al . (1 9 9 7 ) . L o n g i t u d i n a l s t u d yon t h eP r o c e s so fbecomingaP a r e n t . ， ) 7 2 8 3 . HumanDevelopment a lR e s e a r c h .5(1 tal .( 19 9 4 ) . ThreeM o t h e r s :F o l U j i i eTatsuo，e low up Study o fT r a n s i t i o n a lP r o c e s st o Motherhood. TheJ a p a n e s eJ o u r n a lo fD e v e l opmentalPsychology， 5(2)， 1 2 3 1 3 6 ..

(7) 「窺となる力Jを形成する過程の分析. 7 9. (Summary). 「親となる力 J を形成する過程の分析一初回健診で妊婦と助産師はどのような関係にあるのか藤井真理子 1)、日限ふみ子 2)、坪田. 明子 2). 滋賀県立大学人間看護学部. 1). )国際医療福祉大学大学院. 2. 3人の妊婦はそれぞ、れ心配事、不安や悩みを持っ. 背景今日、見童虐待に代表されるような膏児問題は大きな社会的問題になってきている O そこで、それらの問. 結果. 題を解決するための方法も取り組まれてきている O しかしながら、これらの多くは子どもが産まれてからの対応. 室では、妊婦たちはあせらされることなく自分のペースで行動し、ゆったりと思い出しながら話すことが出来て. に焦点をあてたものであり、妊娠期からの支援は少ない。特に「殺となる力」を育むために妊娠期での他者との関係性に焦点をあてたものは見あたらない。. いた。彼女たちは助産師に妊娠に伴う身体的な変イヒを把握してもらうだけでなく、生活全般の悩みを助産師に語っ. 目的本稿では親となる形成過程を明らかにする第一段階として、看護職者(助産師)が妊婦にどのように関わり、妊婦と助産師がどのような関係にあるのかを明らかにする。. . N市の助産院に来院した妊婦 2 6人の健診場面方法 1 . 初めての健診で、妊婦自らが満足を参加観察した。 2 . 同意が得られしたと語った 3人を分析対象とした。 3 た妊婦と助産師の会話や表培、しぐさといったノンパーパルコミュニケーションの全内容を記述し分析を行った。. ていた。これらは助産師との対話の中で語られた。診察. ていた。一方、助産師は妊娠や健康に関する項目を明確に質問している。しかし妊婦の不安、迷いの訴えに対しては、さりげなく尋ね、妊婦たちの思いを無理に聞き出すことはしていない。妊婦たちを見つめながら、気持ちのこもったタイミングのよい相づちを打つだけで、あった。結論. 初回の妊婦健診において助産師と妊婦たちの関係. は、信頼(甘えることができる)関係を形成していた。キーワード親となる力、助産師一妊婦関係、サポート、信頼(甘え). 助産院、.

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