%0 Journal Article
%T Experts' Encounters in Antenatal Diabetes Care: A Descriptive Study of Verbal Communication in Midwife-Led Consultations
%A Christina Furskog Risa
%A Febe Friberg
%A Eva Lid¨Śn
%J Nursing Research and Practice
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/121360
%X 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. 1. Introduction In line with the global increase in prediabetes and diabetes, a significant rise in the proportion of diabetes during pregnancy has been reported. Women with diabetes are regarded as a high-risk group with respect to maternal, fetal, and neonatal outcomes [1]. According to the Medical Birth Registry in Norway [2] reporting for the year 2008, diabetes was reported in 2.1% of all pregnancies. Diabetes type I (T1DM) and type II (T2DM) were diagnosed in 0.4% and 0.3%, respectively, of the pregnancies in 2009. Gestational diabetes mellitus (GDM) was recorded in 1.4% of pregnancies, a number that has doubled during the last decade. In Norway, antenatal care for diabetes pregnancies is delivered in hospital outpatient clinics by multidisciplinary diabetes teams, in line with national guidelines for diabetes in pregnancy [3]. In this team, the midwife is responsible for continuity of follow-ups of the developing pregnancy. In addition, the midwife provides information and advice related to the consequences of living with diabetes and the expressed needs of the woman. Several studies point to the fact that midwifery consultations are perceived as valuable for the women [4, 5], but there is
%U http://www.hindawi.com/journals/nrp/2012/121360/