출산에서의 여성전문직 조산사의 기능과 쇠퇴에 관한 연구 (A Study on the Role and Decline of the Midwife as Female Childbirth Professional)

서지정보

· 발행기관 : 한국구술사학회
· 수록지 정보 : 구술사연구 / 6권 / 1호 / 121 ~ 161페이지
· 저자명 : 이임하

초록

이 글은 여성 전문직종의 하나로 여성의 임신과 출산을 조력하는 일을 담당했던 조산사의 구술을 토대로 조산사의 성장과 쇠퇴, 의료기술의 규제와 통제, 출산과 여성의 몸이라는 소재를 다루었다. 문헌 자료가 풍부하지 않은 현실에서 조산사의 구술은 조산사의성장과 쇠퇴를 알려준다. 이런 측면에서 2008년 수집된 국사편찬위원회의 ‘원로산파구술’은 조산사의 역사를 밝히는 중요한 자료이다.
한국 사회에서 1990년대까지 출산의 조력자였던 조산사는 상당히 안정적인 지위를갖고 있었다. 그러나 2000년대 이후 조산사는 급속히 쇠퇴했으며 조산원도 거의 폐원되었다. 이들 구술자들은 조산원을 개원해 조산의 일을 20~50년 동안 해왔다. 그들의 구술을 통해 조산 업무, 조산사에 대한 의료제도와 기술의 통제가 진행되었는지, 산모와의관계를 어떻게 풀어갔는지 등의 문제를 제기할 수 있다.
구술자들에 따르면 조산원의 쇠퇴는 종합병원의 증가와 대형화, 조산사의 재생산 방식, 제도적 미비 등이다. 특히 조산사에 대한 의료기술과 지식의 통제는 크게 두가지 방식으로 진행되었다. 하나는 정상과 이상의 경계짓기와 다른 하나는 의료도구와 약품의 사용에 대한 통제였다. 이러한 통제는 조산사들의 응급대체 능력을 저하시켰을 뿐만 아니라의료시장에서의 경쟁력 상실로 이어져 조산원 폐원의 길로 이끌었다.
국사편찬위원회의 ‘원로산파구술’에서 조산사들은 ‘엄마 같은 손길로 해주기’, ‘산모와슬픔과 기쁨 함께 나누기’, ‘진심으로 대하기’, ‘완전한 내 책임’ 따위로 산모들과 관계를풀어갔다.

영어초록

This study dealt with the following research subjects: the rise and fall of the midwife, regulation and control of medical technology, childbirth and women’s bodies based on the oral history of midwives who had played a main role in the process of pregnancy and childbirth among women as female professionals. In the face of the lack of literature on these subjects, the oral history of midwives has provided much needed information about the rise and fall of the midwife. For this, ‘the Oral history of Elder Midwives’ collected by the National Institute of Korean History is a very important resource to shed light of the real history of midwives in Korea.
The midwives, helper on childbirth until 1990’s in Korea, held stable social economic status. However, this occupation declined after 2000’s very rapidly and their workplaces, maternity centers, also quickly disappeared.
These oral history interviewees had opened these maternity centers and worked as midwives for twenty to fifty years. This history made it possible to draw out the following research questions: How did the medical institution and technology control the midwife and maternity nursing? And how have midwives dealt with the relationship with the mothers.
Based on the narrator of this oral history, the decline of maternity centers resulted from the increase and enlargement of general hospitals, the process of the reproduction of midwives, and lack of institutional support. In particular, the control of medical technology and knowledge onto the midwives were conducted in two ways. First, it occurred by drawing a boundary between normal and abnormal and second, by controlling the use of medical instruments and medicine. That is, doctors tightly controlled the midwives’ use of only deficient tools with lower level than doctors.’ This control worked well; it reduced the capability for midwives to handle emergency situations, and this tendency brought about the loss of their competency in the medical market leading to the demise of many of maternity centers. Now, after the 2000’s most childbirth occurs in hospitals, up to the 99% level. Hospital childbirth has accelerated the medicalization of childbirth, while making the recognition of pregnancy and childbirth into a disease during this process; women have been pushed toward psychological burdens more and more.
From ‘the Oral history of Elder Midwives’ collected by the National Institute of Korean History, is was found that the midwives dealt with the relationship with the mothers by ‘care giving like a graceful mother’, ‘sharing sorrow and joy with mother,’ ‘facing the mother from the bottom of one’s heart,’ and ‘taking all my responsibility’ and so on. In other words, this research has important implications for the current moment, with suggestions for an alternative childbirth culture, different from the system of large general hospitals, such as those relating to the remarkable elements of childbirth in maternity centers run by midwives.

참고자료

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