IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v307y2022ics0277953622004877.html
   My bibliography  Save this article

“Who am I to say?” Dutch care providers' evaluation of psychosocial vulnerability in pregnant women

Author

Listed:
  • van Blarikom, Esca
  • de Kok, Bregje
  • Bijma, Hilmar H.

Abstract

Maternity care increasingly focuses on evaluating psychosocial vulnerability during pregnancy. Research and nationwide (public health) programs, both in the USA and Europe, led to the development of new protocols and screening instruments for care providers to systematically screen for psychosocial vulnerability in pregnant women. However, standardised screening for vulnerability is complex since it requires discussion of sensitive issues. Women may fear stigmatisation and may have limited trust in their care providers or the health system. Our study contributes to the growing field of client-facing risk work by exploring care providers' interpretations and evaluation of psychosocial vulnerability in pregnant women. Drawing on semi-structured interviews with Dutch maternity care providers, we explore how they conceptualise risk and vulnerability and identify ‘vulnerable pregnant women’ in their practices. We find that care providers conceptualise ‘vulnerability’ as primarily based on risk, which contributes to an imbalanced focus on individual mothers, rather than on both parents and the social context. Our findings highlight care providers' concerns around ‘care avoidance’, seen as a risk factor affecting ‘vulnerability’ during pregnancy and as a possible consequence of risk screening. The care providers we interviewed employ “in between-strategies” based on intuition, emotion, and trust to skillfully attend to the risk that comes with risk work, in terms of its potential impact on relationships of trust and open communication. We conclude that ‘vulnerability’ should be understood as a multi-layered, situated and relational concept rather than simply as an epidemiological category. Since a trusting relationship between pregnant women and care providers is crucial for the evaluation of vulnerability, we reflect critically on the risk of standardised perinatal psychosocial risk evaluations. Policy should recognise providers' “in between-strategies” to embed epidemiological understandings of risk in the context of everyday risk work.

Suggested Citation

  • van Blarikom, Esca & de Kok, Bregje & Bijma, Hilmar H., 2022. "“Who am I to say?” Dutch care providers' evaluation of psychosocial vulnerability in pregnant women," Social Science & Medicine, Elsevier, vol. 307(C).
  • Handle: RePEc:eee:socmed:v:307:y:2022:i:c:s0277953622004877
    DOI: 10.1016/j.socscimed.2022.115181
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953622004877
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.socscimed.2022.115181?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Kaur, Navjotpal & Ricciardelli, Rosemary, 2020. "Negotiating risk and choice in multifetal pregnancies," Social Science & Medicine, Elsevier, vol. 252(C).
    2. Greenhalgh, Joanne & Flynn, Rob & Long, Andrew F. & Tyson, Sarah, 2008. "Tacit and encoded knowledge in the use of standardised outcome measures in multidisciplinary team decision making: A case study of in-patient neurorehabilitation," Social Science & Medicine, Elsevier, vol. 67(1), pages 183-194, July.
    3. Sharp, Gemma C. & Lawlor, Deborah A. & Richardson, Sarah S., 2018. "It's the mother!: How assumptions about the causal primacy of maternal effects influence research on the developmental origins of health and disease," Social Science & Medicine, Elsevier, vol. 213(C), pages 20-27.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Turner, Simon & Higginson, Juliet & Oborne, C. Alice & Thomas, Rebecca E. & Ramsay, Angus I.G. & Fulop, Naomi J., 2014. "Codifying knowledge to improve patient safety: A qualitative study of practice-based interventions," Social Science & Medicine, Elsevier, vol. 113(C), pages 169-176.
    2. Broom, Alex & Adams, Jon & Tovey, Philip, 2009. "Evidence-based healthcare in practice: A study of clinician resistance, professional de-skilling, and inter-specialty differentiation in oncology," Social Science & Medicine, Elsevier, vol. 68(1), pages 192-200, January.
    3. Butler, Clare, 2019. "Working the 'wise’ in speech and language therapy: Evidence-based practice, biopolitics and ‘pastoral labour’," Social Science & Medicine, Elsevier, vol. 230(C), pages 1-8.
    4. Cong Feng & Scott Fay & Kexin Xiang, 2021. "When do we need higher educated salespeople? The role of work experience," Review of Managerial Science, Springer, vol. 15(5), pages 1391-1429, July.
    5. Baeza, Juan I. & Boaz, Annette & Fraser, Alec, 2016. "The roles of specialisation and evidence-based practice in inter-professional jurisdictions: A qualitative study of stroke services in England, Sweden and Poland," Social Science & Medicine, Elsevier, vol. 155(C), pages 15-23.
    6. Corinne Moser & Michael Stauffacher & Pius Krütli & Roland W. Scholz, 2012. "The Crucial Role of Nomothetic and Idiographic Conceptions of Time: Interdisciplinary Collaboration in Nuclear Waste Management," Risk Analysis, John Wiley & Sons, vol. 32(1), pages 138-154, January.
    7. Ducey, Ariel & Donoso, Claudia & Ross, Sue & Robert, Magali, 2020. "From anatomy to patient experience in pelvic floor surgery: Mindlines, evidence, responsibility, and transvaginal mesh," Social Science & Medicine, Elsevier, vol. 260(C).
    8. Neely, Eva, 2023. "Theorising mother-baby-assemblages: The vital emergence of maternal health," Social Science & Medicine, Elsevier, vol. 317(C).
    9. Jun Suzurikawa & Yuki Sawada & Miwa Sakiyama & Motoi Suwa & Takenobu Inoue & Tomoko Kondo, 2021. "Perspectives of Multidisciplinary Professional Teams during Assessment Processes for ATD Selection in the Japanese Public Provision System," IJERPH, MDPI, vol. 18(5), pages 1-16, March.
    10. Elstad, Emily A. & Lutfey, Karen E. & Marceau, Lisa D. & Campbell, Stephen M. & von dem Knesebeck, Olaf & McKinlay, John B., 2010. "What do physicians gain (and lose) with experience? Qualitative results from a cross-national study of diabetes," Social Science & Medicine, Elsevier, vol. 70(11), pages 1728-1736, June.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:307:y:2022:i:c:s0277953622004877. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.