Att göra det ovanliga normalt : Kommunikativ varsamhet och medicinska uppgifter i barnmorskors samtal med gravida kvinnor

Sammanfattning: This thesis is a study of the encounters between midwives and expectant mothers within Swedish maternal health care (MHC). The aim of this study is to describe and analyse the communicative interaction between midwives and pregnant women at the MHC centres. The study focuses upon how the parties' actions and conversations contribute to the solution of the communicative problems that must be resolved during the different stages in pregnancy. The data have been drawn from authentic encounters between midwives, who are qualified nurses working within preventive MHC units, and expectant mothers, who pay regular visits to these units. The data include fieldwork notes and interviews but the core data are the tape-recorded (and observed) midwife-pregnant women talks (at times with fathers also present).The communicative problems that must be resolved concern, among other things, the development of the pregnancy and the child-to-be, the management of sensitive topics, and the presentation of medical technology. How this is done in talk and interaction is analysed in detail in this study. Results show that midwives indulge in a massive discursive effort to portray pregnancies in general and the individual woman's pregnancy in particular in terms of normality. Pregnancy can be seen as a risky project, but talking about risks would seem to threaten the aim of the communicative project. The discourse between midwives and women during pregnancy displays what I call communicative caution. This includes informing without causing anxiety, using discourse and the medical technology to create and recreate the normal and natural in the pregnancy, handling risks without explicitly talking about them, and treating sensitive topics with discretion. The overall aim of the communicative projects, is, accordingly, to create confidence and self-reliance, and to avoid anxiety among the pregnant women.