月嫂介入女性产后抑郁的实践策略与政策启示  

Practical Strategies and Policy Implications of Postpartum Doulas'Intervention on Postpartum Depression

作　　者：邢朝国[1] 郇建立[1] XING Chaoguo(Sociology Department,University of Science and Technology Beijing,Beijing,100083,China)

机构地区：[1]北京科技大学社会学系,北京100083

出　　处：《医学与社会》2021年第4期11-16,共6页Medicine and Society

基　　金：国家社会科学基金资助项目,编号为19BSH011;中央高校基本科研业务费资助项目,编号为FRF-DF-20-10。

摘　　要：与在医院对产妇进行医疗护理干预的医护人员不同,月嫂进入到产妇的家庭场域中对产后抑郁进行观察、理解和介入。基于对月嫂的深度访谈,发现产后抑郁与产妇的爱恨情感体验以及家庭矛盾勾连在一起:一方面家庭矛盾导致产妇陷入抑郁风险之中;另一方面,产妇抑郁行为表现容易触发家庭矛盾,使家庭关系更加紧张。月嫂作为有过婚姻经历和生育经验的女性,容易对抑郁产妇形成高水平共情,理解抑郁产妇的情绪和需求。月嫂通过重新定义产妇冲突行为、将抑郁产妇去污名化、强调产妇的生育贡献和产后脆弱性、阐述产后抑郁的后果等策略来调解家庭矛盾,促使家人忍让和关心产妇。总体上,月嫂介入产后抑郁实践呈现出“以产妇为中心”倾向,即“让产妇顺心”。当前医院开展的产后抑郁预防干预作用有限,而产后抑郁的社区预防干预则可以从本文厘清的产后抑郁发病之社会性机制中获得启发,将家庭作为预防干预单位,重视建立良好的干预关系,在家庭政治中为抑郁产妇赋权增能。Different from the nursing intervention of medical staff in the hospital space,the postpartum doulas enter into the family field of the depressed puerpera,where they observe,understand and intervene in Postpartum Depression(PPD)in the daily life.Based on the in-depth interview,the paper finds that PPD is connected with the depressed puerpera's love,hate and family conflicts.On the one hand,the depressed puerperas are infuriated by family conflicts which will put them in the risk of PPD.On the other hand,the depressed puerperae could easily trigger family conflicts,which will make their family relationship more unfavorable.As women who are married and have childbearing experience,the postpartum doulas can easily form a high level of empathy with the depressed puerperas.The postpartum doulas use some strategies to help them get family support,including redefining conflict behavior of the depressed puerperas,helping them get rid of the stigmatization of PPD,emphasizing on maternity contribution and postpartum vulnerability,elaborating the consequences of PPD and so on.On the whole,the practice of postpartum doulas'intervention in PPD shows a"puerpera-centered"tendency,that is,to"make the puerpera happy".The study further clarifies the social mechanism of postpartum depression,but the current prevention and intervention from hospital is limited.The community intervention program of PPD can be inspired from the practice of postpartum doulas,including taking family as a preventive intervention unit,paying attention to developing good intervention relationship,and empowering and enabling postpartum depression women in family politics.

关 键 词：产后抑郁 月嫂 家庭支持 

分 类 号：R192.9[医药卫生—卫生事业管理]