カジャン・ホスピタル産科の50年--マレーシアにおける出産の病院化の過程

Abstract

This paper examines the process of institutionalization of child delivery practices in Malaysia for the last fifty years. The main data analyzed are the "Delivery Record Books" of 1957 through 2000 which are found at the Kajang Hospital located approximately 26 km southeast of Kuala Lumpur. A historical analysis of the data indicates considerable differences in delivery practices between three major ethnic groups in Malaysia; in the earlier period Chinese and Indian women were predominant in the Delivery Record Books, while Malay women, evidently preferring to give birth at home with the assistance of bidan kampung (traditional midwives), were scarcely represented. These findings imply that Chinese and Indians, many of who had immigrated to Malaya as laborers, had greater access to modern medical care under the maternal and child health policy of the British colonial government because the reproduction of laborers was given high priority during the colonial period. It was only after the 1960s that medical projects such as the construction of midwife clinics were brought into rural areas where the majority of Malays lived. In these clinics, the government midwives started to assist Malay women in their deliveries and advise them to deliver at the nearby hospital if any complications were expected. The government also imposed strict rules to prohibit bidan kampung from providing child delivery services. Hence, the number of Malays in the rural areas who gave birth at the Kajang Hospital increased dramatically in the 1960s, especially after the 1970s.