미혼여성 임신 전 출산건강 관리지원 방안 연구: 학교 및 지역사회 기반의 생식건강 교육 환경 개선

Abstract

건강한 임신과 출산을 위한 임신 전 출산건강관리(preconception care)는 미혼 여성을 포함한 모든 가임기 여성들을 대상으로 한 예방적 접근이다. 더불어 이러한 임신 전 관리는 의료 영역뿐만 아니라, 교육 및 사회서비스 등 다양한 비의료영역들 간의 다양한 협업을 강조한다. 이 연구는 현재까지 임신 이후에 한하여 초점이 맞추어졌던 출산건강 관리를 청소년을 포함한 미혼여성까지 확대하여 포괄하고 있다. 그리고 이 연구는 이들이 주로 접하는 학교 및 지역사회에 기반 한 생식건강 교육을 통한 미혼여성들의 생식건강 증진 방안을 모색한다. 청소년을 포함한 미혼여성을 대상으로 실시한 실태조사와 학교와 지역사회의 생식건강 교육 담당자를 대상으로 한 심층면접 등을 통해 생애적 관점의 통합적인 임신 전 출산건강 관리 정책을 제안한다.

Medical and nonmedical health care during pregnancy is well known as the determinants of healthy birth outcomes. However, these outcomes could be affected by the cumulative results of health behaviors across all life stages. Since reproductive health education as preconceptional care can be very important for unmarried women, and as a consequence, this study focuses on their school- and community-based reproductive health education status and problems. This study divides those unmarried women aged 15~34 years old into three groups, such as adolescents, university students and adults. For adolescents, health education in school is not obligated and reproductive health is included in health education, and as the result, reproductive health education is not sufficient. Furthermore, school health teachers and counselling teachers are not merely connected in order to help those students who need some things for their reproductive health. For university students, contrast to adolescents, they should personally choose and ask for reproductive health education and/or counselling because this education is not under the obligation. In university, health centers and sexual counselling centers provide reproductive education and consultation for students, but are not connected together, and then community-based education programs from health care centers, medical centers and so on are hardly to intervene. For adults who graduated from school and/or university, they can take education services by multiple community-based health and sexual centers. However, as university students, adults also actively ask for reproductive health education and then the service quality from these centers in community are very different. Based on the findings of these population groups, we suggested several ways of policy support on reproductive health education for adolescents, university students and adults, respectively.