Some lessons from Swedish midwives' experiences of approaching women smokers in antenatal care.
OBJECTIVE
to describe the qualitatively different ways in which midwives make sense of how to approach women smokers.


METHODS
a more person-centred national project 'Smoke-free pregnancy' has been in progress in Sweden since 1992. Using a phenomenographic approach, 24 midwives who have been regularly working in antenatal care were interviewed about addressing smoking during pregnancy.


RESULTS
four different story types of how the midwives made sense of their experiences in addressing smoking in pregnancy were identified: 'avoiding', 'informing', 'friend-making', 'co-operating'.


CONCLUSIONS
the midwives' story types about how they approached women who smoke illustrated the difficulties of changing from being an expert who gives information and advice to being an expert on how to enable a woman in finding out why she smoked and how to stop smoking.


CONCLUSIONS
health education about smoking that is built on co-operation and dialogue was seen by the midwives as a productive way of working. The starting point should be the lay perspective of a woman, which means that her thoughts about smoking cessation are given the space to grow while she talks.
Abrahamsson
Agneta
A
Department of Health Sciences, Kristianstad University, SE-291 88 Kristianstad, Sweden. Agneta.Abrahamsson@hv.hkr.se
Springett
Jane
J
Karlsson
Leif
L
Håkansson
Anders
A
Ottosson
Torgny
T
D000328:Adult; D005260:Female; D006801:Humans; D008880:Midwifery / Q000379:methods*; D009035:Mothers / Q000193:education* / Q000523:psychology; D033262:Narration; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D010353:Patient Education as Topic / Q000379:methods; D011247:Pregnancy; D011248:Pregnancy Complications / Q000451:nursing / Q000517:prevention & control*; D011295:Prenatal Care / Q000379:methods*; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D013548:Sweden