台灣婦女的產後憂鬱處境：結構不義與孕產婦心理健康研究

Abstract

在台灣，孕產心理健康已逐漸從私人疾病轉變為公共衛生議題，然而現有政策似乎力有未逮。雖然醫學與女性主義文獻已指出孕產婦健康受到生心理與社會環境因素影響的重要性，但針對此議題的倫理探討仍付之闕如。本研究嘗試從社會結構與正義理論的視角切入，繪製出屬於台灣孕產婦的社會處境圖像，並分析之中是否存在結構不義的問題。這份錨定於台灣社會的理論建構透過規範性分析與實證研究兩部分完成。第一部分援引政治理論家Iris Marion Young的理論，結合女性主義文本與產後憂鬱相關文獻，勾勒出跨社會的孕產婦群體皆可能面對的基本社會結構內容，也藉此建立一套初步的結構性分析框架。第二部分進行質性實證研究，採半結構式訪談法，訪談對象包含2022至2025年間曾在台灣有孕產經驗的婦女及其同住家庭成員，共計21人。訪談內容涵蓋孕產歷程、育兒壓力、社會支持等面向，透過蒐集與爬梳台灣的經驗，以建立一個更完整的、能夠解釋和描述台灣孕產婦女處境的理論內容。研究發現，台灣孕產婦女面臨「主要照顧者」、「注意健康的母親」、「被教導者」、「身心損傷」、「情緒孤島」五類結構性困境，而Young所提出的五種壓迫樣貌—剝削、邊緣化、無力、文化帝國主義與暴力—皆可在之中見到具體展現。由此可見，台灣婦女的產後憂鬱處境，不僅是一種由多重社會因素交織而成的情緒反應，更是一種與壓迫密切相關的結構不義問題。

In Taiwan, maternal mental health is increasingly recognized as a public issue, yet current policies remain insufficient. While medical and feminist literature emphasize the influence of psychological and social factors, ethical and structural reflections remain limited. This study examines postpartum depression as a potential form of structural injustice by analyzing the social conditions faced by perinatal women in Taiwan through the lens of social structure and justice theory. The research combines normative and empirical approaches. The first part draws on Iris Marion Young’s theory, feminist literature, and studies on postpartum depression to develop a framework for understanding the structural challenges commonly encountered by perinatal women. The second part involves semi-structured interviews with 21 participants—women who gave birth in Taiwan from 2022 to 2025 and their cohabiting family members. Interviews explore themes such as pregnancy experiences, parenting stress, and social support. Findings reveal five structural conditions faced by Taiwanese perinatal women: being the “primary caregiver,” the “health-conscious mother,” the “one to be instructed,” and experiencing “bodily and psychological harm” and “emotional isolation.” These conditions reflect all five faces of oppression identified by Young: exploitation, marginalization, powerlessness, cultural imperialism, and violence. Postpartum depression, therefore, is not merely an individual emotional response but a manifestation of structural injustice rooted in broader patterns of social oppression.