Experts' Encounters in Antenatal Diabetes Care: A Descriptive Study of Verbal Communication in Midwife-Led Consultations

Abstract

Aim. We regard consultations as cocreated communicatively by the parties involved. In this paper on verbal communication in midwife-led consultations, we consequently focus on the actual conversation taking place between the midwife and the pregnant woman with diabetes, especially on those sequences where the pregnant woman initiated a topic of concern in the conversation. Methods. This paper was undertaken in four hospital outpatient clinics in Norway. Ten antenatal consultations between midwives and pregnant women were audiotaped, transcribed to text, and analyzed using theme-oriented discourse analysis. Two communicative patterns were revealed: an expert's frame and a shared experts' frame. Within each frame, different communicative variations are presented. The topics women initiated in the conversations were (i) delivery, time and mode; (ii) previous birth experience; (iii) labor pain; and (iv) breast feeding, diabetes management, and fetal weight. Conclusion. Different ways of communicating seem to create different opportunities for the parties to share each other's perspectives. Adequate responses and a listening attitude as well as an ambiguous way of talking seem to open up for the pregnant women's perspectives. Further studies are needed to investigate the obstacles to, and premises for, providing midwifery care in a specialist outpatient setting.

The Perspectives of Diabetes Educators and Dietitians on Diet and Lifestyle Management for Gestational Diabetes Mellitus: A Qualitative Study

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Norwegian nurse-midwives’ perspectives on the provision of antenatal diabetes care in an outpatient setting: A qualitative study

“…[21][22][23] Five hospital clinics were initially approached; of these, four agreed to participate in the study. The head midwife at each setting provided contact with midwives at the S-ANC who then were given written and oral information about the study by the first author.…”

Person‐centred conversations in nursing and health: A theoretical analysis based on perspectives on communication

“…When the midwife ‘palpates the abdomen’ to check the foetus, a kind of existential meaning is conveyed in expecting a baby and becoming a mother. In Furskog Risa, 2017 view, this bodily, ‘hands‐on’ communicative activity opens up for the woman to share comments and questions, and for the midwife, palpating the abdomen (Leopold's manoeuvre) can be seen as a profession‐specific communicative tool. This is an example of communicative strategies that are situationally adapted.…”

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