剖宫产行为的人类学研究——以川东G私立医院为例

An Anthropological Study of Cesarean Section Delivery:A Case Study of G Private Hospital in East Sichuan

近二十年来,我国孕产妇尤其是农村孕产妇主动选择导致的剖宫产率持续上升,私立医院成为实施剖宫产术最多的医院。公立医院严守着国家控制剖宫产率的管理规定,私立医院选择遵从“以病人为中心或主导”的医疗服务理念,孕产妇尤其是农村孕产妇为了回避传统观念强调的分娩之“痛苦”记忆而主动要求行剖宫产,这是当下生育文化中的一种突出现象。深入考察分娩方式选择变化的过程及其动因,可以看到人口流动、市场经济、医疗制度改革、生活方式变化以及年轻女性地位提升、价值追求变化等诸多因素在发挥着综合作用。同时,分娩方式变化这一现象所呈现出来的人们消费观念的变化,女性生育模式从顺其自然走向自主选择、从被动接受转变为强调自我权力实现、由他者主导到自我决定的转变,公立医院对规则的严守,私立医院对管理规定的巧妙规避等,充分展现了内涵于急剧变迁社会中存在的各种复杂现象和动因,揭示社会变迁中各种外显或内隐现象的深层次含义和本质,有助于更好地认知变化,处理好社会变迁过程中的各种利益诉求。

In recent 20 years,the cesarean section rate caused by the active choice of pregnant women,especially rural women,has been rising,and private hospitals have become the most popular.Public hospitals,however,strictly abide by the state management regulations to control the cesarean section rate.In contrast,private hospitals often choose to comply with the“patient-centered or patient-oriented”medical service philosophy.Pregnant women,especially pregnant women in rural areas,actively request cesarean section to avoid the“painful”memory of childbirth,which is a prominent phenomenon in the current fertility culture.An in-depth study of the process and motivation of the change in the choice of delivery modes reveals that many factors such as population mobility,market economy,reform of the medical system,change in the lifestyle and value orientations,and improvement of the young women's status all have played their roles.At the same time,changes in the childbirth model,a manifestation of various changes such as the change of people's consumption concept,the change of women's childbearing model from letting nature take its course to independent choice,from passive acceptance to emphasizing the realization of self-power,from the other’s dominance to self-determination,public hospitals’adherence to established rules,and private hospitals’circumvention of management regulations,reveal complex phenomena and motives in the rapidly changing society.Such revealing of the rich implications and the essence of various explicit or implicit phenomena in social changes is helpful to better understand the changes and to deal with various interests and demands in the course of social development.