조선시대 태교 담론에서 바라본 이사주당의 태교론

정해은 ( Chung Hae-eun ) 한국여성사학회 2009 여성과 역사 Vol.- No.10

이 논고는 李師朱堂(1739~1821)이 지은 『胎敎新記』를 조선시대 태교 전통과 관련하여 검토한 글이다. 이 논고에서 주안점을 둔 부분은 『태교신기』가 18세기 말이라는 시대와 어떤 관련을 맺고 있는지, 어떤 사유의 전통 속에서 재구성되었는지에 대하여 주목하였다. 조선에서 통용되던 태교를 조사해보면 대부분 『열녀전』의 내용을 축약한 것으로, 의외로 매우 단순하고 소략하다. 중국 周나라 초기 여성인 太任을 모델로 삼아 생활 속에서 여성들에게 의식주를 조심하라는 데에 중점을 두었다. 사주당이 주창한 태교 역시 『열녀전』을 비롯하여 기존의 논의에 뿌리를 두고 있으나 거기에 담긴 주장은 새로운 것이었다. 사주당의 주장은 폭넓은 독서와 경험을 바탕으로 당대까지 태교와는 확실히 다른 지점에 서있었다. 사주당이 주창한 태교란 『열녀전』에서 강조하던 생활 속에서 의식주 등을 삼가는 데에서 성큼 나아가, 이러한 삼감[謹]을 기꺼이 하기위한 마음을 창출하도록 도덕적인 수양을 요구하였다. 요컨대, 사주당은 태교에 성리학적 가치 즉 `修身`이라는 새로운 성격을 부여하면서 여성들에게 태교를 통해 도덕질서 속에 발을 들여놓도록 적극 권장하였다. 또한 사주당은 많은 사람들이 태교를 여성의 임무로 한정시킨 데 비해, 부부와 가족이 공동으로 참여하는 프로젝트로 탈바꿈시켰다. 그러나 『태교신기』에서 만나는 여성의 역할과 몸가짐·마음가짐에는 사주당이 기꺼이 내면화한 성리학이 추구하는 남성 중심의 가치가 투영되어있음도 간과할 수 없다. In this article, a book called 『Taegyo-Shin`gi/胎敎新記(New approach on Prenatal care)』, authored by a female named Sajudang/師朱堂 Yi(李氏: 1739~1821) is examined, inside the context of Joseon dynasty period`s tradition of prenatal care. Especially examined in this article is what kind of relationship this 『Taegyo-Shin`gi』 had with the environment provided by the time(ending days of the 18th century), and in what kind of philosophical tradition this text tried to reconstruct and reimagine the prenatal care practices of the time. The prenatal care in Joseon had been practiced as dictated in 『Yeol`nyeo-jeon/列女傳』. This text emphasized the message of (females`) being careful in food, clothes and residence, while featuring a character named Tae`im/太任, a figure from the early days of the Chinese Ju/周 dynasty. Sajudang also based her discussions of prenatal care upon this 『Yeol`nyeo-jeon』, yet her arguments were quite different from what had been discussed in the past. The practice of prenatal care Sajudang argued went way beyond being careful and prudent in terms of taking food, clothes and residence(as emphasized in 『Yeol`nyeo-jeon』), and asked the readers to go through certain moral character building efforts, which would produce a state of mind that would show eagerness to maintain prudence[謹]. In short, Sajudang added a Neo-Confucian value(the `character-building efforts[修身]`) to the existing prenatal care practice, and strongly asked all the females to step into the moral order through the prenatal stage designed in such fashion. Sajudang also enlarged the scope of `prenatal care` to involve not only the pregnant females but the entire family, making it a familial project so to speak. But it should also be noted that inside 『Taegyo-Shin`gi』, which reflected Neo-Confucian values that Sajudang accepted and embraced, a position supporting an `ideal` management of females` mind and body(with a male-centered value system embedded in it) was to be found as well.

唐代 理想的 人間型 - 胎敎를 중심으로 -

김종섭 중앙대학교 중앙사학연구소 2012 중앙사론 Vol.0 No.36

Prenatal educational care(胎敎) is artificially creating a child's character but is not inherently to accept that is given. In the Han age(漢代), prenatal educational care was made to enlighten disorderly life of the imperial family, main targets were women. In the Tang age(唐代), education was valued to an unborn child at prenatal educational care, main targets changed to an unborn child. This change became a chance for spreading from imperial family to the people prenatal educational care. The main contents of prenatal educational care is contents of Zhouwenwang(周文王)`s mother. This contents of education was transmitted into after ages. According to development of society contents of prenatal educational care was diversified by medical books, buddhism etc. Liu Xiang(劉向) argued that ideal type of human being was 'a decent appearance(容貌端正)' and 'a great talent(才德過人)' through prenatal educational care. The Tang people(唐人) thought that ideal type of human being was 'filial piety and brotherly love(孝悌)', 'extraordinary'. It is a little difference to compare idea of Liu Xiang and Tang people. But this ideal type of human being was restricted to boundary of confucianism. This mean there is another function to prenatal educational care. That is a primary function in social control. Not only pregnant women but also her husband have to be careful of behavior until a child’s birth. As a result, prenatal educational care was contributed to stability of society. Therefore, in tang ages, prenatal educational care was operated as means of social control, produced ideal type of human being in limitation of confucianism.

효과적인 산전관리를 위한 고객관계관리(CRM)의 도입

신숙 ( Sook Shin ),백수경 ( Soo Kyung Paik ),강성홍 ( Sung Hong Kang ),김유미 ( Yu Mi Kim ) 한국병원경영학회 2005 병원경영학회지 Vol.10 No.1

The prenatal care is the preventive medical service to help the pregnant mother deliver the healthy baby. It`s regular examines give some chances to check-up the healthy conditions. This thesis concentrates on the CRM system to support an effective prenatal care system and prove the effectiveness of it. As CRM is the adapted management related to the customer`s own information, it is important to develop the CRM model classified by the patients characteristics. A general hospital in Busan operated the CRM system to carry out the effective prenatal care and there is an analysis to ensure the effectiveness of CRM system for the pregnant women in our maternity ward. The results can be summarized as follows: 1) According to the comparisons with the CRM system, we can conclude the system is desirable. (1) Maternal Age : In the age distribution, the prenatal visit frequency, triple marker freqency, oral G1 I` and targeted ultrasonography in the experimental group in 30 to 34 years old is higher on the whole. For over 35 years old group, the higher frequency comes out in the oral G I? and targeted ultrasonography and for 25 to 29 years old group the different figure shows just in the targeted ultrasonography. (2) Area of residence : There is a clear difference in all the items in Busan and near area but no sign of difference in prenatal visits and oral GIF in other residential area. Especially in the targeted ultrasonography the higher figure shows in the experimental group located in the both areas. The targeted ultrasonography is known as the specific examination which should be examined by the specialists, on the contrary the other examinations can be operated in the small clinic. So the public information and seminars related with ultrasonography increases the check-up frequency. The clinic requests some ultrasonographical examinations to the specialists in general hospital. (3) Parity : The clear difference shows that the CRM system causes the prenatal visit frequency to become higher in experimental group. The figure is 9.7 times and 8.6 times each. This is opposite that the past study said multiparity reduced the average prenatal visits. But the result of CRM is considered as the method to help the multiparity understand the importance of the prenatal care. (4) Obstetrical history : In the experimental group of the spontaneous delivery group, the figure is higher in the prenatal visit frequency, triple marker, oral G1T and targeted ultrasonography but the Caesarean section delivery group has higher figure in targeted ultrasonography. (5) In the first check-up, the rate of targeted ultrasonography in under 16 week pregnancy, in the 16 week pregnancy to 32 week pregnancy and the over 32 week pregnancy in the experimental group is upper than the compared one. For the oral GIP, there is a difference in under 16 week pregnancy but no difference in prenatal visits and triple marker. 2) The analysis of characteristics of prenatal care through the decision tree resulted in the fact that the most important variable is the residential area. After the delivery frequency is following, the obstetrical history and maternal age are in order. It is the same result in the triple marker and oral GT T. Consequently it is the same order of important variables in CRM system. The effectiveness of CRM system is proved in this study. The CRM system is a marketing method to control and lead the customers through the segmentation of customer data. It increases the new customer aquisition, maintenance of loyal customers, augmentation of customers value, activation of potential customers and creation of life time customers. So eventually it can enlarge the customers value. The medical institution should make efforts to establish the data base enforced by the customer`s information on the underlying ordinary data system to carry out the CRM system effectively. In addition, it should develop the a variety of marketing strategy in order to set u

한방 산전관리에 관한 인식 조사

최가야,김경직,조정훈,장준복,이경섭 대한한방부인과학회 2004 大韓韓方婦人科學會誌 Vol.17 No.4

Objectives : The study is to analyse the cognition of antepartum care and to aid the progress of oriental medical antepartum care on modern life style. Method : We studied with questionnaire from Dec. 2001 to Mar. 2003 in KMC OB&GY. A questionnaire was given to 297 women delivered of a child. Results and conclusions : The chief complain during pregnancy are hyperemesis, urgency, backpain and so on but the effect of western medical treatment of these symptom is not sure. The prenatal care that respondents tried are medical checkup at regular interval and the other remedies are not seem to be generalized. Only 13.5% respondents have experience of oriental medical prenatal care and the purposes are mainly for ability, delivery and care of hyperemesis with herb medication and most of them are satisfactied with the effect of oriental treatment. Most of 86.5% respondents have no experience don't know about oriental medical prenatal care. In consequence, if publicity of oriental medical prenatal care program was effectively achieved, many pregnant women will show affirmative response.

임상 ; 적절한 산전 관리를 받지 않은 임산부와 신생아의 주산기 합병증

최병민 ( Byung Min Choi ),송영우 ( Young Wooh Song ),신정희 ( Jeong Hee Shin ),윤영선 ( Young Sun Yoon ),정현철 ( Hyun Chul Jeong ),임형은 ( Hyung Eun Yim ),이정화 ( Jung Hwa Lee ),김해중 ( Hai Joong Kim ),홍영숙 ( Young Sook H 대한주산의학회 2010 Perinatology Vol.21 No.4

목적: 산전 관리는 임산부와 신생아의 건강 증진을 위해 중요한 것으로 우리 나라의 사회 경제적 여건이 개선 되면서 대부분의 임부가 산전 관리를 받고 있지만 아직도 경기도 일부 지역에서는 적절한 산전 관리를 받지 않은 임산부와 신생아가 있으나 이들에 대한 국내의 보고는 없는 실정이어서 이들의 주산기 합병증에 대하여 조 사하였다. 방법: 2004년 1월부터 2009년 12월까지 고려대학교 부속 안산 병원 신생아 중환자실 및 신생아실에 입원한 신 생아의 어머니 중 산전 관리를 3회 이하로 받은 임산부를 대상으로 하여 후향적으로 의무 기록을 분석하였다. 대상 임산부는 106명, 대상 신생아는 107명으로 재태 연령이 부정확한 경우는 새로운 발라드 법을 이용하여 재 태 기간을 추정하였다. 이들에 대하여 임산부의 분만력과 주산기 합병증을 조사하였고 신생아의 인구역학적 특징과 주산기 합병증, 선천성 기형 및 사망률을 조사하였으며 본원 의료 사회사업팀에서 연계한 의료 지원에 대 하여 알아보았다. 결과: 대상 임산부는 2004년도에 12명이었고 2005년도에 14명, 2006년도에 9명, 2007년도에 15명, 2008 년도에 28명, 2009년도에 28명으로 최근에 적절히 산전 관리를 받지 못하는 임산부와 신생아가 늘어나고 있는 추세를 보였다. 임산부의 주산기 합병증으로는 조산이 35명(33.0%), 빈혈 20명(22.9%), 조기 양막 파수 15 명(17.2%), 융모양막염 14명(16%), 태반 조기 박리 6명(6.8%), 다발성 질벽 열상 6명(6.8%), 전자간증 4명 (4.5%)이 있었다. 신생아의 주산기 합병증으로 미숙아가 44명(41.1%)이었으며 이중 재태 기간 28주 미만의 미 숙아는 7명(6.5%)이었다. 저체중 출생아는 44명(41.1%)으로 극소 저체중 출생아 17명(15.8%), 초극소 저체중 출생아 7명(6.5%)이었다. 대상 신생아 중 재태 연령 34주 미만의 미숙아 26명에 대하여 같은 기간 동안 적절히 산전 관리를 받았던 임산부에게서 출생한 재태 연령 34주 미만의 미숙아 52명을 대조군으로 설정하여 이들의 주산기 합병증에 대하여 비교한 결과, 적절한 산전 관리를 받았던 임산부에게서 태어난 미숙아에 비해 대상 미 숙아들의 호흡곤란 증후군의 발생이 더 많았고(P =0.044), 부당 경량아가 더 많이 태어났으며(P =0.038), 3단계 이상의 뇌출혈 또한 유의하게 더 많이 발생하였다(P =0.040). 또한 선천성 기형아와 사망아의 비율도 높았으며 특히 전전뇌증(holoprosencephaly)이나 Beare-Stevenson 증후군과 같이 생존율이 매우 낮은 기형아의 출생 도 있었다. 대상 환아 중 37명(34.5%)이 입양 기관으로 이송되었고, 1명은 아동보호시설로 퇴원하였으며, 13명 (12.1%)은 보호자의 경제적 사정으로 보건소, 재단, 교우회, 시청 등에서 진료비 지원을 받았다. 결론: 본 연구에서 적절한 산전 관리를 받지 않는 경우 임산부와 신생아의 주산기 합병증의 이환율이 증가하고 임산부의 사회경제적인 여건으로 인하여 사회적 부담도 발생함을 알 수 있었다. 이들은 대부분 저소득층 및 미 성년자와 같은 소외 계층으로 국가에서 운영하는 보건소의 무료 산전 관리 프로그램의 혜택을 받지 못했고 이를 개선하기 위해 야간 및 주말에도 산전 관리 진료를 운영하는 등의 실질적인 국가 정책의 활성화와 소외 계층 에게 정보를 제공하기 위한 홍보 및 교육 프로그램 개발의 필요성이 절실히 요구된다. Objective: With improvement in the social and economic states of Korea, most of the pregnancies have been appropriately examined but there are a few mothers and newborns who have not received proper prenatal care. The aim of this study was to investigate obstetrical and neonatal complications resulting from inadequate prenatal care. Methods: The medical records of 107 neonates who had received prenatal care lesser than 3 visits and admitted to the neonatal intensive care units of Korea University Ansan Hospital from January 2004 to December 2009 were retrospectively reviewed. Obstetrical complications, neonatal gestational age, birth weight, neonatal complications were analyzed. We compared neonatal complications of the inadequate prenatal care group and those of the adequate prenatal care group lesser than 34 weeks` gestational age neonates. Results: In obstetrical complications, there were twenty women with anemia, fifteen cases with premature rupture of membranes, and fourteen chorioamnionitis. In neonatal complications, there were forth-four premature infants, and forty-four low birth weight infants. Respiratory distress syndrome, small for gestational age, severe intraventricular hemorrhage were more common in the inadequate prenatal care group than the adequate prenatal care group. Thirty-seven infants (34.5%) were sent to the adoption agency. Fifty infants (46.6%) received medical expense support by the social service. Conclusions: Obstetrical and neonatal complications and social burden were increasing when the pregnancies had not received adequate prenatal care. To reduce perinatal complications of mothers and neonates in low socioeconomic classes, practical nation`s policies and social supports for adequate prenatal care should be provided.

Accessibility of Prenatal Care Can Affect Inequitable Health Outcomes of Pregnant Women Living in Obstetric Care Underserved Areas: a Nationwide Population-Based Study

곽미영,이승미,이태호,은상준,이진용,김윤 대한의학회 2019 Journal of Korean medical science Vol.34 No.1

Background: As of 2011, among 250 administrative districts in Korea, 54 districts did not have obstetrics and gynecology clinics or hospitals providing prenatal care and delivery services. The Korean government designated 38 regions among 54 districts as “Obstetric Care Underserved Areas (OCUA).” However, little is known there are any differences in pregnancy, prenatal care, and outcomes of women dwelling in OCUA compared to women in other areas. The purposes of this study were to compare the pregnancy related indicators (PRIs) and adequacy of prenatal care between OCUA region and non-OCUA region. Methods: Using National Health Insurance database in Korea from January 1, 2012 to December 31, 2014, we constructed the whole dataset of women who terminated pregnancy including delivery and abortion. We assessed incidence rate of 17 PRIs and adequacy of prenatal care. All indicators were compared between OCUA group and non-OCUA group. Results: The women dwelling in OCUA regions were more likely to get abortion (4.6% in OCUA vs. 3.6% in non-OCUA) and receive inadequate prenatal care (7.2% vs. 4.4%). Regarding abortion rate, there were significant regional differences in abortion rate. The highest abortion rate was 10.3% and the lowest region was 1.2%. Among 38 OCUA regions, 29 regions' abortion rates were higher than the national average of abortion rate (3.56%) and there were 10 regions in which abortion rates were higher than 7.0%. In addition, some PRIs such as acute pyelonephritis and transfusion in obstetric hemorrhage were more worse in OCUA regions compared to non-OCUA regions. Conclusion: PRIs are different according to the regions where women are living. The Korean government should make an effort reducing these gaps of obstetric cares between OCUA and non-OCUA.

태아의 인지 발달과 여성의 심리적 돌봄을 위한 옛이야기 태교 스토리텔링 연구

박시언 한국문학치료학회 2024 문학치료연구 Vol.72 No.-

본 연구는 우리 사회의 저출산 문제에 기인하여 여성의 관점에서 태교 활동이 지향해야 할 바를 점검하고자 하였다. 이에 따라 현재 우리나라에서 시행되는 태교 방법 및 형태를 살펴보고, 기존 태교 방식에서 발생하는 문제의 근본을 파악하는 것을 통해서 여성의 태교에 관한 전망과 나아갈 방향을 타진하는 것을 목표로 한다. 옛이야기는 우리 삶의 ‘희로애락(喜怒哀樂)’을 담고 있다. 즐거움과 슬픈 안에 깃들어 있는 인간 실존 및 생존과 관련된 다양한 코드가 옛이야기 안에 숨겨져 있다. 옛이야기는 인간 삶을 이해하고, 성찰하게 하며 또 치유의 속성을 포함한다. 본 연구는 옛이야기를 통하여 여성의 삶을 엿보고 그 속에서 임산부에게 도움이 되고 태아에게 좋은 영향을 끼칠 수 있는, 옛이야기와 그 속에 담긴 효용적인 요소를 포착하여 실질적으로 태교에 활용할 수 있는 방안을 마련하고자 하였다. 또한 ‘임신-출산-육아’라는 여성의 현실적인 심리적, 돌봄의 문제라는 정서적 측면을 고려한 옛이야기 태교 스토리텔링 방법이 고안되어야 한다는 문제의식에서 출발하였다. 옛이야기를 활용한 기존 태교에서는 옛이야기 선정 기준과 해석의 문제가 문제점으로 거론되는 점, 현실적인 여성의 태교와 그 의미와 맥락이 연결되지 못한 바를 포착하였다. 진짜 여성에게 필요한 이야기, 여성의 문제를 담고 있는 이야기이면서도 삶의 힘듦을 공유하고, 태아에게 도움이 될 수 있는 이야기를 발굴해야 한다. 옛이야기는 경험과 지식 습득 체계를 습득하는 것 이상으로 인간의 인지 및 내적인 영역에도 관여할 수 있다. 아울러 옛이야기에는 인간의 확신이 숨겨져 있어서 어떠한 상황에서도 포기하지 않는 인간만의 고유한 능력과 공감을 일으키고 정서적으로 불안과 걱정에 휩싸인 임산부를 위로하며, 지지하는 역할과 그러한 기능을 수행할 수 있다. 옛이야기는 임산부의 심리적 안정감을 되찾아 주고, 그 안정과 효과로 태중 태아의 발달에 기여할 수 있다는 의의가 있으므로 옛이야기를 통한 태교 스토리텔링의 활용을 모색하였다. In this study, we sought to to examine what women would want from prenatal care. The aim was to identify the problems of prenatal care by examining the methods and forms of prenatal care currently implemented in Korea, and to explore the future prospects and directions for prenatal care among women. Old stories contain our joys and sorrows. Various codes related to human existence and survival, embedded in joy and sorrow, are hidden in the form of story. These old stories include understanding, reflecting, and healing properties. Through old stories, This study conducts a preliminary review to identify a narrative that can help pregnant women and positively affect the fetus, and help prepare a practical method for prenatal care. Prenatal methods should be devised considering the practical problems and emotional aspects of women, called ‘regnancy-birth-parenting’. In traditional prenatal education using old stories, we found a story that contains women’s problems and shares the difficulties of women’s lives, as it captures the problem of selecting old stories and interpreting them as problems. Old stories can be more involved in the internal field of human beings than in acquiring experience and knowledge acquisition systems. Human conviction is hidden in old stories, thus they create unique abilities and empathy for humans who do not give up under any circumstances, comfort and support pregnant women who are emotionally disturbed and worried. Old stories is meaningful because they can restore the psychological stability of pregnant women and contribute to the development of fetuses by facilitating greater stability.

Pregnancy, Prenatal Care, and Delivery of Mothers with Disabilities in Korea

임남구,박주옥,이정아,오주환,이진영 대한의학회 2015 Journal of Korean medical science Vol.30 No.2

The aim of this study was to investigate the whole picture regarding pregnancy, prenatalcare, obstetrical complications, and delivery among disabled pregnant women in Korea. Using the data of National Health Insurance Corporation, we extracted the data of womenwho terminated pregnancy including delivery and abortion from January 1, 2010 toDecember 31, 2010. Pearson’s chi-square test and Student-t test were conducted toexamine the difference between disabled women and non-disabled women. Also, todefine the factors affecting inadequate prenatal care, logistic regression was performed. The total number of pregnancy were 463,847; disabled women was 2,968 (0.6%) and460,879 (99.4%) were by non-disabled women. Abortion rates (27.6%), Cesarean sectionrate (54.5%), and the rate of receiving inadequate prenatal care (17.0%), and the rate ofbeing experienced at least one obstetrical complication (11.3%) among disabled womenwere higher than those among non-disabled women (P < 0.001). Beneficiaries of MedicalAid (OR, 2.21) (P < 0.001) and severe disabled women (OR, 1.46) (P = 0.002) were morelikely to receive inadequate prenatal care. In conclusion, disabled women are morevulnerable in pregnancy, prenatal care and delivery. Therefore, the government and societyshould pay more attention to disabled pregnant women to ensure they have a safepregnancy period up until the delivery.

産母의 分娩 醫療機關 選擇要因

송영혜,박재용,차병준 대한보건협회 1994 대한보건연구 Vol.20 No.2

산모들의 의료기관 선호요인을 규명하기 위하여 1994년 4월 1일부터 1994년 4월 30일 사이에 부산시내 각급 의료기관에서 분만한 산모(2개 대학병원 57명, 3개 종합병원 171명, 4개 병원 198명, 3개 개인의원 99명, 3개 조산소 141명) 총 666명을 대상으로 설문 조사한 결과는 다음과 같다. 조사대상 분만산모의 평균연령은 28.4세였고 각 의료기관별로 선정된 분만산모는 남편직업과 종교분포는 유의한 차이가 있었다. 조산소 분만자는 출산순위가 둘째인 경우가 많은 반면 다른 의료기관은 첫째가 가장 많았다. 조산소 분만자는 전부가 질식분만이었지만 제왕절개 분만은 의원에서는 40.4%, 대학병원에서는 29.8%로 오히려 의원에서 높았다. 그리고 대학병원 분만자는 임신합병증이 있는 경우가 17.5%로 다른 의료기관 보다 높았다. 그러나 의료기관별로 임신기간, 산전관리 횟수, 유산경험 등은 통계적으로 유의한 차이가 없었다. 분만기관에 대한 정보원은 각 의료기관 모두에서 가족·친지가 가장 많았고 의료기관 선택 결정자는 본인이 가장 많았다. 분만기관과 산전관리기관과의 일치율은 각 의료기관에서 모두 60% 이상으로 높게 나타났지만 의료기관별로 분만기관과 산전관리기관이 다른 경우도 대학병원 분만자에서 38.6%로 가장 높고, 병원 분만자에서 29.3%로 가장 낮게 나타났다. 분만을 위해 의료기관을 옮긴 가장 흔한 이유는 대학병원과 종합병원에서 분만한 산모들은 안전분만이, 병원과 의원은 진료수준이, 조산소는 이용편리였다. 분만기관 선호요인은 조산소를 제외한 모든 의료기관에서는 의술신뢰를, 조산소는 이용편리를 제1순위로 지적했으며, 제2순위는 병원급 이상에서는 의사친절, 의원에서는 전통과 전문성, 그리고 조산소는 간호사·직원 친절을 들고 있다. 각급 의료기관간의 선호요인들의 순위상관계수는 0.8이상으로 높아 분만기관별로 선호요인의 뚜렷한 차이를 발견하기 어려웠다. 결국 산전관리기관과 분만기관의 일치율이 60-70% 정도이고 의료기관별로 분만자의 특성 내지는 선호요인에도 큰 차이가 없음을 감안하면 앞으로 산전관리기관과 분만기관이 일치할 수 있도록 분만에 관련된 의료체계의 개편방안이 강구되어야 할 것이다. This study was conducted to investigate the preferring factors about selection of delivery facilities by pregnant women. A total 666 parturient women who delivered a baby at 15 delivery facilities; 2 university hospitals, 3 general hospitals, 4 hospitals, 3 clinics, and 3 midwifery clinics in Pusan, between April 1 and April 30, 1994 were selected for a questionnaire survey. The survey results were as follows : 1. The average age of the women included in the study was 28.4 year of age, and the distribution was not significantly different by the delivery facilities. 3. Many of the parturient women at midwifery facilities were second delivered, but majority of them at another facilities were primiparous. 4. All of parturient women at midwifery facilities were vaginally delivered, but deliveries by cesarean section were 40.4% at clinics, 29.8% at university hospitals. The 17.5% of parturient women at university hospitals were having pregnancy-complications and its rate was higher than that at another facilities. Statistically significant differences were absent in pregnancy duration, frequency of prenatal cares, abortion experiences according to medical services. 5. The information sources about delivery facilities were most from family and relatives in all facilities, and determination on facility selection was most from parturient themselves. 6. The concordance rate of delivery facilities versus prenatal-care facilities was all high in each facility, and disconcordance rate was highest in university hospitals (38.6%), and lowest in hospitals(29.3%). 7. The most common reason for which pregnant women had changed medical services for delivery was safe delivery in university and general hospitals, and medical service level in hospital and clinics, and use-convenience in midwifery facilities. 8. Factors for selecting delivery-factor was primarily medical technique trust except midwifery facility, and there it was use-convenience, and secondarily in hospital-above level, it was doctor-kindness, in clinics it was tradition, professionalism, in midwifery facility it was nurse, other employee-kindness. Spearman correlation of selection factors for each medical services was higher than 0.8, and so remarkable differences was not able to be detected. After all, concordance rate of prenatal care versus delivery facility was about 60-70%, and differences were absent in parturient characteristics to selection factors according to medical services, and so forwards for more concordance of prenatal care and delivery facility, it was be thought that innovative plan of medical system related to delivery be prepared.

일부지역 임산부의 구강건강관리에 대한 조사연구

이가연 ( Ka Yean Lee ) 한국치위생학회 2009 한국치위생학회지 Vol.9 No.1

The purpose of this study was to examine the oral health care awareness of pregnant women and their actual oral health care in an effort to provide information on how to assist pregnant women to have the right knowledge on oral health and improve their oral health care. The subjects in this study were pregnant women who used obstetrics and gynecology hospitals or participated in pregnancy/child-rearing programs in the region of P. After a self-administered survey was conducted in July and August 2008, the following findings were given: 1. As for the best case of oral health care, the largest number(77.2%) of the pregnant women investigated brushed all the teeth, gums and tongue when they did toothbrushing. The smallest number of the women(6.8%) spent three minutes or more brushing their teeth. 2. As to dental treatment experience during pregnancy by age, 27.0 percent of the age 26-30 group had ever received dental treatment during pregnancy, which was higher than the rates of the other age groups with the same experience. 3. Regarding the necessity of oral health education geared toward pregnant women, 94.1 percent of the age 26-30 group and 96.3 percent of the group of age 31 and up felt the need for that, which were significantly higher than 72.7 percent of the age 20-25 group who agreed to the necessity of that education. 4. As to connections between oral health status and oral health care, the women who were in good oral health got 6.60 on oral health care. They scored significantly higher than those who were in a moderate state of oral health and who were in bad oral health, as the latter two groups respectively got 5. There was a significant correlation between oral health state and oral health care and between oral health knowledge and oral health care. The better oral health status led to better oral health knowledge, and the better oral health knowledge was followed by better oral health care. 6. As for factors affecting oral health care, oral health knowledge had the largest impact on that, followed by age, oral health status, experience of receiving oral health education for pregnant woman, dental treatment experience during pregnancy, monthly income and stress caused by oral diseases. Given the findings of the study, oral health education should be provided in light of the special physical and mental state of pregnant women. They should be encouraged to receive possible dental treatment during pregnancy if necessary, and they should learn about how to cope with a dental disease in case of develop it.