Towards understanding the concept of risk for pregnant women: some nursing and midwifery implications

Authors

  • Mary C Carolan

    1. Author:Mary C Carolan, BN, PhD, MPH, RN, RM, Senior Lecturer in Midwifery, Director of Midwifery Education, School of Nursing and Midwifery, Victoria Institute of Health and Diversity, Victoria University, Melbourne, Australia
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Mary C Carolan, Senior Lecturer in Midwifery, Director of Midwifery Education, School of Nursing and Midwifery, Victoria Institute of Health and Diversity, Victoria University, PO Box 14428, Melbourne 8001, Australia. Telephone: +61 3 9919 2252.
E-mail:mary.carolan@vu.edu.au

Abstract

Aims and objectives.  This paper aims to explore the concept of risk in pregnancy.

Background.  Notions of risk and ‘not knowing’ have always surrounded pregnant women, although in the last two decades trends of increased consumer confidence and midwifery activism have together promoted a greater appreciation of pregnancy as a normal life event. At the same time, advances in pregnancy-related technologies have contributed new levels of concern related to an increasing ability to detect minor abnormalities by ultrasound. This, in turn, causes a concordant rise in the number of women referred to high-risk pregnancy care to monitor suspect findings. Overall, it seems likely that this increasing emphasis on abnormality detection and risk may have serious implications for women.

Design.  Concept analysis.

Method.  In this paper, I undertake an exploration of the concept of risk as understood by health professionals and pregnant women. Then, using Deborah Lupton’s understanding of a ‘discourse of risk’, I discuss the ways pregnant women both contribute to and are enmeshed in, this discourse. In the final section, I consider how nurses act informally to shield vulnerable women.

Conclusions.  Health professionals and pregnant women understand risk differently. Women employ a subjective appraisal of risk, measuring it against their personal values and prior experience, while health professionals evaluate risk in an objective manner.

Relevance to clinical practice.  As increasing numbers of women are referred to ‘at risk’ care, it is important that health professionals understand and respond to maternal understandings of risk. Nurses and midwives particularly, have a role to play in assisting women to make sense of risk calculations. In this way, they can act to ameliorate the growing concept of risk for pregnant women.

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