title: From Braxton Hicks to preterm labour: the constitution of risk in pregnancy.
abstract: With the recent introduction of preterm birth prevention programs there has been a shift in our understanding of what the presence of contractions during pregnancy means and a reconstituting of risk in ways that position increasing numbers of women at risk for preterm birth. This paper highlights the findings of a study exploring the influences of risk discourses on women's experiences of preterm labour. The primary goals of this institutional ethnographic study were to describe the effects of societal discourses, institutional structures, and nursing work processes on the everyday lives of childbearing women experiencing preterm labour. The findings suggest that risk discourses exert social control over pregnant women and result in fear, guilt, feelings of being judged or punished, and an overwhelming sense of personal responsibility for preventing preterm birth. The study also exposes ways in which biomedical constructions of risk and preterm labour affect the organization of health services, including nursing practice.
authors.affiliation: Rural Maternity Research, Vancouver, British Columbia, Canada. karenm@ruralmatresearch.net
authors.forename: Karen
authors.initials: K
authors.lastname: MacKinnon
authors.forename: Marjorie
authors.initials: M
authors.lastname: McIntyre
mesh_terms: D000223:Adaptation, Psychological; D000884:Anthropology, Cultural; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002170:Canada; D005239:Fear; D005260:Female; D017144:Focus Groups; D006167:Guilt; D006801:Humans; D007389:Internal-External Control; D024802:Nurse's Role; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000523:psychology; D007752:Obstetric Labor, Premature / Q000517:prevention & control / Q000523:psychology; D011247:Pregnancy; D018566:Pregnancy, High-Risk / Q000523:psychology*; D037841:Pregnant People / Q000523:psychology*; D018570:Risk Assessment; D012307:Risk Factors; D012648:Self Care / Q000379:methods / Q000523:psychology; D011795:Surveys and Questionnaires; D014590:Uterine Contraction / Q000523:psychology*