苗栗頭份客家庄女性生育與作月子的文化照護變遷

Abstract

中文摘要 客家族群從大陸移民到臺灣後，落實於開墾的土地上，苗栗縣頭份鎮東庄里的李屋伙房為傳統的客家庄父系社會，聚族而居，以四縣客語為主。在四時節慶行祭祀，當有新成員加入時，雞酒香氣在巷弄迴盪，滿月時製作油飯、紅蛋、新丁粄分送親朋好友，在七娘生為小孩祈福帶絭(daiken，戴上平安符)等，日常生活一切以傳統客家文化展現。 生育是人類週而復始的自然現象，在這過程中漢文化的「作月子」，是非常獨特且深具內涵的一種儀式行為。女性在宣告、淨化、重建、人際重整過程中，文化認知是一個重要因素。它影響個人價值觀、生活習慣及家庭信仰、健康的照護知識等，主宰婦女整個孕產過程。當女性由婚姻進入夫家宗族時，如何在生子作月子儀式中角色晉級，嵌入親屬重疊環扣聯繫，擴展社會人際、家庭網絡、延伸家族脈絡，如何適應社會變遷的論述。 頭份鎮的婦女若生產或求診，因地利之便，至為恭醫院診療，而為恭是頭份地區，現今唯一有接生之區域醫院。筆者在臨床護理經驗中，發現產婦常需面對文化習俗和醫療照護的衝突，及作月子場域的抉擇。護理人員在實務中，因應社會變遷，面對不同族群的生活方式及文化內容，亦需調整不同層級的重要措施。 本研究採質性研究、田野調查、深入訪談、參與觀察，應用日出模式照護理論做為研究指引，尋找多元因素，採全貌性觀點，探討客家傳統習俗與現今文化照護的變遷。並針對婦女孕產知識及作月子行為分析，瞭解產婦實際需求，讓產婦不再自我限縮，並有多重選擇，達到身心各項需求予以完整照護的目的。

Abstract

The native Hakka ethnic group, immigrating from China to Taiwan, first settled down on the cultivated land where they built Laivuk Hakka Village, Tung-chuang as their hometown in Toufen Township, Miao-li County as a traditional Hakka village and a typical patriarchal society, living together, mainly speaking the Taiwanese (Si-yan) Hakka dialect and sacrificing on Ember Days

When a baby is newly born, there usually the fragrance of chicken wine permeating around all the alleys and lanes, when it is one month old, people will prepare to serve glutinous rice, boiled egg with its shells red-dyed and newcomer dumplings or cakes, as gifts for their close friends and relatives and also pray for Daiken for children by putting on them protective talismans blessed by Seventh Star Goddess.

The human procreation is a natural phenomenon for producing offspring.Such traditional Hakka cultural practice or rituals manifest themselves in their everyday life. The “puerperal period” is a very unique and profound Chinese cultural ritual or practice during which time, women are being proclaimed, spiritualized or purified, re-established, with their interpersonal relationships rebuilt. Thus, in the process, culture awareness is an important element which influences individual’s values, living habits and family beliefs, knowledge about health care and determines the whole process of pregnancy and birth.

The discussion is about how women, though marriage, could strive to advance and promote their role when entering, the extended larger families of their husband and, fitting into and broadening the relatively complex family network of their family members and relatives; how they could expand or strengthen their interpersonal relationships; and how they could manage to adjust to the social changes in the practice of observing puerperal period, thus integrated into their husband’s values and briefs.

When giving birth to their babies or seeing a doctor, the women in Toufen would mostly go to the Wei-gong hospital for medical treatments since it is the only regional hospital that offers delivering service in Toufen. It is found from the research that in his clinical nursing experience pregnant women often needs to face with the conflicts between cultural customs and medical care as well as the choice of location for practicing their puerperal period. Accordingly these nurses also experience the need to making various key measurements to adjust to different levels of life style and cultural rituals or practice in response to the social changes. This research adopted qualitative research, field investigation, in-depth interview, participants’ observation and applied the care theory of sunrise model as the guideline to discuss the traditional Hakka customs and today’s culture care changes by exploring their multivariate factors from a holistic point of view. It also analyzes women’s knowledge about pregnancy and behaviors during confinements so as to understand and determine their actual, realistic needs, thus allowing them to have more options or choices to meet their individual or specific needs for good, decent care instead of self-limiting with no alternative as the previous practice.