編排風險：多胚胎孕育的多重社會科技網絡

Choreographing Risk: Multiple Sociotechnical Networks of Multiple Pregnancy

本文提出「編排風險」概念，探討人工協助生殖科技所引發的多胚胎孕育網絡，並著重分析該網絡的變動性，以及婦女的行動與經驗。主要資料來自婦女訪談、相關醫事人員訪談與檔案資料。本文發現，在多胚胎助孕、受孕與懷孕的歷程，其組成元素與組合模式，往往圍繞著風險來運作，有異質的網絡特性，同時又彼此環環相扣。在助孕的網絡中，醫用雙方都以懷孕失敗作為主要風險，醫界並以多胚胎植入與排卵藥物作為風險處理策略，卻進一步增加了多胚胎孕育的健康風險。醫界提出以減胎當作備用的風險處理措施，然而一些產婦整合出一個混雜了價值、經濟、宗教、身體、情緒、技術等等風險評估綜合體，抗拒進入減胎網絡；另一些產婦雖有意採用減胎措施，卻因為醫師不推薦、不施行，使得減胎網絡經常瓦解。而台灣高比例的多胞胎懷孕，主要由多胞胎孕婦透過身體工作，以及協調生產與再生產勞動，努力支撐起安胎網絡，並承擔其風險後果。透過這三個異質網絡的比較，本文彰顯出婦女在多胚胎孕育歷程中，越來越擔起編排風險的要角，也承擔更多的成敗與後果。在政策意涵上，本文提出醫界在各關卡編排風險的方式，應考量婦女的異質風險觀與利益，並減少多胚胎受孕的發生，降低婦女編排風險的勞心勞力。

This paper creates the concept of 'choreographing risk' to explore the sociotechnical networks of multiple pregnancy, mostly caused by assisted reproductive technology. I argue that during the processes of assisted conception and multiple pregnancy, heterogeneous elements of technology, legality, financial issues, emotions, politics and gender are coordinated around risk. Data include in-depth interviews of women and medical professionals, as well as archival data. I find that at the stage of getting pregnant with assisted reproductive technology, doctors tend to use multiple embryo transfer and ovarian stimulation medication to increase the pregnancy rate. Both doctors and women perceive failure of conception as the major risk and tend to disregard the risk of multiple pregnancy. In the case of multifetal conception, fetal reduction becomes a technical model to reduce the risk of multiple pregnancy. Some women and doctors refuse this technique for reasons other than health risk, however; the network of fetal reduction often collapses. High prevalence of multiple pregnancy in Taiwan exists. Pregnant women of twins and triples take embodied responsibility to avoid the risk of premature birth, including diverse bodily work and negotiation between productive and reproductive labor. This paper shows that women vis-à-vis medical professionals are becoming the central choreographers in the multiple networks of multiple pregnancy. For a policy implication, I suggest adjusting assisted conception methods, such as reducing the number of multiple embryo transfers during in-vitro fertilization, to relieve women from the hard labor of multiple risk choreography.