多胞胎孕婦接受減胎手術的生活經驗

Lived Experience of Multifetal Pregnant Women with Fetal Reduction

本研究目的為探討多胞胎孕婦接受減胎手術的生活經驗。採質性研究設計，以田野研究法於北市某婦產科診所進行。研究對象為接受減胎手術之多胞胎孕婦，共10位。研究者以研究對象之諮詢護理師的身份，一面提供照護，一面收集資料。資料收集始於個案初次接受諮詢至減胎後五週止，每位各約五次面訪及八次電訪，訪談內容以文字記錄，採現象學解釋性分析。本研究結果由資料歸類出多胞胎孕婦接受減胎之生活經驗有七個類目，依其減胎前、中、後三階段分別為：（一）減胎術前：多胎妊娠確認之脅迫感、胚胎生命取捨的罪惡與衝突；（二）減胎術中：家人關切增添困惑、身體界面受侵犯、對存留胎兒安全之擔憂；（三）減胎術後：對失去胎兒之哀傷、重新踏入孕育歷程的常軌。減胎手術帶給孕婦身心衝擊，建議醫療人員應依其獨特性及時序性給予整體性的照護。

The purpose of this study was to explore the lived experience of multifetal pregnant women who underwent fetal reduction. Using a qualitative research design, we recruited ten multifetal pregnant women with fetal reduction from an obstetrics and gynecology clinic in Taipei. The researcher, as a nurse counselor, collected data while providing care. Data were collected during the first counseling scheduled prior to the fetal reduction to five weeks post the procedure. Approximately five face-to-face interviews and eight phone follow-ups were completed for each subject. Data were recorded in a narrative form and analyzed based on interpretive research strategies of phenomenology. According to the data, the lived experience was categorized into seven themes: (a) pre-fetal reduction: feeling threatened by the confirmed diagnosis of multifetal pregnancy, facing guilt and conflict of undergoing fetal reduction; (b) undergoing fetal reduction: getting confused due to family's concern about fetal reduction, losing a sense of body boundary intactness, and worrying about the safety of the remaining fetuses; (c) post-fetal reduction: grieving for losing fetus, returning to the course of normal pregnancy. The findings indicate that undergoing fetal reduction impacted the physical and psychological well-being of multifetal pregnant women. Health care providers should provide individual yet holistic care in a timely fashion.