title: Norwegian nurse-midwives' perspectives on the provision of antenatal diabetes care in an outpatient setting: A qualitative study.
abstract: BACKGROUND
  There is limited research related to nurse-midwives' accounts of their provision of antenatal diabetes care in hospital outpatient settings. This study explored the perspectives and experiences of eight Norwegian nurse-midwives regarding the provision of the midwifery aspect of an antenatal consultation as part of the diabetes specialist team.
  
  
  METHODS
  A qualitative descriptive study was used. Eight nurse-midwives aged between 37 and 58 years, representing four Norwegian hospital outpatient clinics, participated in individual interviews. Transcribed interviews were analysed in accordance with a qualitative thematic analysis.
  
  
  RESULTS
  Three main themes were developed: "Approaching the women as persons in order to frame strengths and normalcy", "Managing different tasks judiciously" and "Balancing conflicting values". Some of the barriers were found to be related to the organisation of care, such as short timeframes with a medical focus, which overshadowed or forced the normalcy aspects of childbearing into the background. Managing risk and evidence-based knowledge were demanding tasks to fulfil in a judicious way. Some midwives experienced ambiguity while being forced to prioritise medical factors over woman-focused care while running others' errands, an act of balancing conflicting values.
  
  
  CONCLUSIONS
  The contextual conditions related to the organisation present barriers for pregnant women to receive woman-focused care beyond the medical approach. The midwifery contribution in this care setting should be clearly recognised and defined so that women can capitalise on the different professionals and their expert competencies and contributions in this setting.
authors.affiliation: Faculty of Social Sciences, Department of Health Studies, University of Stavanger, Stavanger, Norway. Electronic address: christina.f.risa@uis.no.
authors.forename: Christina Furskog
authors.initials: CF
authors.lastname: Risa
authors.affiliation: Faculty of Social Sciences, Department of Health Studies, University of Stavanger, Stavanger, Norway. Electronic address: febe.friberg@uis.no.
authors.forename: Febe
authors.initials: F
authors.lastname: Friberg
authors.affiliation: Institute of Health and Care Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden. Electronic address: eva.liden@gu.se.
authors.forename: Eva
authors.initials: E
authors.lastname: Lidèn
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D001291:Attitude of Health Personnel; D016640:Diabetes, Gestational / Q000451:nursing; D005260:Female; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009721:Nurse Midwives / Q000523:psychology*; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D011247:Pregnancy; D037841:Pregnant People; D011295:Prenatal Care / Q000379:methods / Q000458:organization & administration*; D015397:Program Evaluation; D036301:Qualitative Research; D011795:Surveys and Questionnaires
keywords: Diabetes outpatient clinics; Experiences; Nurse midwives; Prenatal care; Qualitative research