新中国成立初期上海助产士的式微及其原因(1949-1966)

Midwifery in Shanghai in the Early Decades of the People’s Republic of China(1949-1966)

助产士是20世纪中国妇幼卫生工作的主要力量。中华人民共和国成立后,助产事业得以延续。因中等卫生教育培养模式趋向全科,助产教育呈式微态势。新老助产士进入国家妇幼保健体系后,其层级定位是既要向上"助"产科医师,又要向下"启"接生员,然而,实际工作中助产士与产科医师间的明确职权界限、助产士与接生员间的业务竞争关系成为助产士进一步式微的原因。加之分娩医疗化趋势、助产士无独立职称体系等新困境出现,助产士一职最终被国家卫生部门划入护士序列。

Midwives were an important group in primary care in China in the 20 th Century. After the founding of the People’s Republic,midwifery continued. However,when the mid-level medical education was expanded to include all aspects including education on labor and delivery,which then became a specialty. After the old and new midwives entered into the state system of primary care,they were faced with a transition of either moving up as assistants of obstetricians or moving downward as assistants of labor and delivery. In fact,in practice,it is the divide of the responsibilities between the obstetricians and their assistants and the competition between the obstetricians’ assistants and assistants of labor and delivery that cause specialization in midwifery. In addition,the medicalization of childbirth created a new condition that led midwives to lose their independence and be classified as a type of nursing by the state health department.