20세기 한국 산파기술의 도입과 발전

Abstract

As childbirth itself is not disease, in traditional society, most families carried out normal deliveries without medical specialists and special skills. However, when an emergency such as difficult delivery and bleeding occurred, even a woman of ripe midwifery experience could not cope with the situation. In that regard, the emergence of obstetricians and midwives transformed Korean childbirth topography in the twentieth century. Because delivery by midwives was limited to normal deliveries, they were hardly able to use surgical measures, medication, and obstetric machines in emergency cases. However, they were able to develop obstetric technology to induce a normal delivery from an abnormal delivery based on plentiful clinical experience. This technology was limited to the finger technique, and even this was not passed down to younger students. Since the first half of the twentieth century, obstetricians have had the opportunity to use different and more advanced technology than midwives, including Caesarian sections and forceps delivery. However, because the development of obstetric technologies such as antibiotics, anesthetics, and blood transfusion was limited, obstetricians had difficulty in performing obstetric operations in this period. After the Korean War of 1950, despite the introduction of new medical technology, obstetrician technology was stagnant due to the economic destruction. The turning point in Korean medicine came after the 1960s. As maternal nutrition was improved by industrialization and modernization, American medicine started to dominate the Korean medical society. Consequently, obstetricians generalized their techniques for episiotomy and forceps delivery. Midwives, who regarded the protection of the perineum as the absolute principle of delivery, also started to use episiotomy. The execution of the National Health Insurance Program in 1977 and Entire Population Medical Insurance in 1989 contributed to the emergence of a hospital centered childbirth culture. With sonograms and the emergence of new antibiotics and anesthetics, obstetricians had a leading position in the childbirth culture. In the course of these developments, midwives were excluded from the childbirth culture, and obstetricians commonly performed Caesarian sections. Furthermore, obstetrics became an unwelcome medical science in the Korean medical society.