【正文】 Pregnancy loss in lesbian and bisexual women: an online survey of experiences 一項網(wǎng)絡問卷調(diào)查研究：女同性戀者與雙性戀者的妊娠丟失 background: ? Although pregnancy loss is a distressing health event for many women, research typically equates women’s experiences of pregnancy loss to ‘married heterosexual women’s experiences of pregnancy loss’. The objective of this study was to explore lesbian and bisexual women’s experiences of miscarriage, stillbirth and neonatal death. ? 雖然妊娠丟失對于大多數(shù)婦女是讓人痛苦的事件，這里卻只是針對正常男女婚配的婦女來說的，而本文旨在針對研究女同性戀者與雙性戀者婦女的妊娠丟失、死胎、新生兒死亡事件。 methods: ? This study analysed predominantly qualitative online survey data from 60 nonheterosexual, mostly lesbian, women from theUK,USA,Canada and Australia. All but one of the pregnancies was planned. Most respondents had physically experienced one early miscarriage during their first pregnancy, although a third had experienced multiple losses. ? 這份調(diào)查源于 60位非異性戀者的網(wǎng)上調(diào)查數(shù)據(jù)，這些非異性戀者主要為女同性戀，囊括英、美、加、澳四地同性戀婦女。所有妊娠多為計劃內(nèi)妊娠，大多數(shù)受調(diào)查者的首次妊娠時就發(fā)生了早期流產(chǎn)，三分之一患者還經(jīng)歷多次妊娠丟失。 results: ? The analysis highlights three themes: processes and practices for conception。 amplification of loss。 and health care and heterosexism. Of the respondents, 84% conceived using donor sperm。 most used various resources to plan conception and engaged in preconception health experience of loss was amplified due to contextual factors and the investment respondents reported making in impending motherhood. Most felt that their loss(es) had made a ‘significant’/‘very significant’ impact on their respondents experienced health care during their loss. Although the majority rated the overall standard of care as ‘good’/‘very good’/‘outstanding’, a minority reported experiencing heterosexism from health professionals. ? 本研究強調(diào)三點： 1懷孕過程與治療 2流產(chǎn)影響的擴大化 3健康護理與受歧視帶來的影響。 84%受調(diào)查者使用精子庫精子受孕，大多數(shù)利用各種資源準備妊娠并參加孕前健康護理。流產(chǎn)影響的擴大化除了與上文提到的三點有關，還與受調(diào)查者為受孕進行的多種投入有關。許多婦女認為妊娠丟失在她們的生活中會產(chǎn)生 “ 重要 ”“ 非常重要 ” 的影響。許多受調(diào)查者在妊娠丟失時正在接受健康護理等治療。雖然大多數(shù)認為護理整體標準 “ 不錯 ”“ 很好 ”“ 特別好 ” ，但仍有少數(shù)稱在護理專業(yè)人員那里受到了歧視。 conclusions: ? The main limitation was that the in flexibility of the methodology did not allow the specificities of women’s experiences to be probed further. It is suggested that both coupled and single nonheterosexual women should be made more visible in reproductive health and pregnancy loss research. ? 主要局限存在于調(diào)查方法的不靈活性，以至于無法適應于每位婦女的特殊性這一問題，故仍需遠期的調(diào)查研究。這項調(diào)查反映出：在生殖健康研究和妊娠丟失研究中，無論非異性戀者的雙方抑或單方婦女是都應該予以關注。 Introduction ? Pregnancy loss is an important issue that affects family planning and childbearing, yet it is often overlooked in reproductive health research,and is shrouded in cultural silence (Layne, 2021). Fetal mortality has also been described as ‘a(chǎn) major. . . public health problem’ (MacDorman and Kirmeyer, 2021a: 1). Pregnancy loss, especially early miscarriage, extremely mon and estimated to occur inbetween 12 and 31% of confirmed pregnancies, and up to as many as half of all pregnancies (Cramer and Wise, 2021。 Cosgrove, 2021。Renner et al., 2021。 Speroff et al., 1999). ? 妊娠丟失影響著家庭計劃與育兒的實施，常被生殖健康中心所忽視，并且掩蓋了道德是非趨向。嬰兒死亡率被認為是一個重要的社會健康問題，妊娠丟失特別是早期流產(chǎn)發(fā)生極普遍，發(fā)生率在經(jīng)證實的妊娠中為 1231%，在整體妊娠中則升至50%。 (Cramer and Wise, 2021。 Cosgrove, 2021。Renner et al., 2021。 Speroff et al., 1999） ? Epidemiological evidencefrom the USA indicates that risk of pregnancy loss is increased for a number of groups of women, including nonwhite women ‘teenagers,women aged 35 years and over, unmarried women and multiple deliveries’(MacDorman and Kirmeyer, 2021b: 1). Within the ‘unmarriedwomen’ category it not possible, however, to discern the sexuality of these women. Furthermore, in many Western jurisdictions marriage, or ‘marriagelike’ legal frameworks, are now available to samesex couples (Harding, 2021。 Peel and Harding, 2021). ? 流行病學證實美國妊娠丟失的風險在婦女在有逐年上升趨勢，包括非白人的青少年團體，年齡大于等于 35歲者、未婚者、多胞胎妊娠者。但是，在未婚婦女這個大范圍中判斷她們的性取向是不容易的，并且在許多西方國家的法律中是允許同性婚姻的。 ? The normative Western narrative of pregnancy is continually reproduced across medical, literary and massmedia resources. It involves a missed period, a positive home pregnancy test and a medically managed pregnancy that entails visits to view the developing ‘baby’ via ultrasound (Davis Floyd and Dumit, 1998。 Harpel, 2021). According to Layne (2021: 27), pregnancy loss at any gestational stage ‘does not conform to the norm’ of joyful pregnancy 。 It also fails to conform to medical norms of correct reproductive embodiment, since it disrupts the myth of continuous, linear ‘biomedical progress’ implicit in dominant Western ‘technobirthing’ discourses that make pregnancy and child rearing the object of rationalizing medical management (DavisFloyd, 1998). ? 西方國家的妊娠標準總是經(jīng)常更新，跨越了從醫(yī)學、道德倫理到大眾傳媒幾個方面，它包括受孕期、自測妊娠試驗陽性及醫(yī)學上妊娠明確（利用超聲可見活胎來明確）。萊恩稱任何階段的流產(chǎn)是不能順應妊娠、分娩這一自然流程的結果， 同樣也是不能適應醫(yī)學角度生殖遺傳標準的結果，因為流產(chǎn)中斷了生物進展的延續(xù)性。這意味著主導西方國家的人工受孕技術使得懷孕和產(chǎn)后嬰兒的醫(yī)學診療方法變得合理必要化。 ? Pregnancy loss is a physically and psychologically distressing event for many women—a form of (often socially unrecognized) bereavement,trauma, significant loss and grief (Renner et al., 2021。Swanson, 2021。 Frost et al., 2021。 Brier, 2021). Furthermore, when nonnormative relational contexts, such as lesbian couples, are considered,the phenomenon bees even more plex. The narrative of ‘normal’ pregnancy begins with ‘natural’ conception, in the context of a heterosexual relationship, usually marriage. Lesbian motherhood is less mon than heterosexual motherhood, and lesbian routes to conception are, by definition, non(hetero)normative and prone to classification as ‘a(chǎn)rtificial’ (Mamo, 2021) even when medical assistance to conceive is not sought (Ferrara et al., 2021). ? 流產(chǎn)不論從身體還是心理方面都是一件讓人痛苦的事，進一步講，非正常關系諸如同性戀夫妻使得流產(chǎn)變得更為復雜。正常懷孕始于 “ 自然 ” 受孕，比如從異性戀愛關系發(fā)展到結婚、生育。而同性戀關系不同與異性戀，所以她們的受孕不能稱之為 “ 自然受孕 ” 而是 “ 人造受孕 ” ，而且沒有足夠的醫(yī)學輔助措施。 ? Nevertheless, estimate